Ex Situ Arterial Reconstruction During Normothermic Perfusion of the Liver.

Nasralla, David, Lembach, Hanns, Mergental, Hynek, Mirza, Darius F, Friend, Peter, Muiesan, Paolo and Perera, Mtpr (2020) Ex Situ Arterial Reconstruction During Normothermic Perfusion of the Liver. Transplantation direct, 6 (9). e596. ISSN 2373-8731.

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Official URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC74474...

Abstract

Background

Aberrant hepatic arterial anatomy may be seen in up to 30% of liver grafts, and reconstruction prolongs the cold ischemic time or the arterialization times. If normothermic machine preservation (NMP) is used to preserve liver grafts, the presence of aberrant arterial anatomy poses a challenge. Dual arterial cannulation is a temporary solution to enable effective perfusion, until optimal circumstances are met for arterial reconstruction, without compromising ischemia time. To date the technical and logistical feasibility of arterial reconstruction ex situ and NMP has not been reported.

Methods

Series of 5 cases from the Consortium for Organ Preservation in Europe randomized controlled trial in which grafts with arterial anatomic variations were reconstructed while organs were perfused on NMP.

Results

One donor after cardiac death and 4 donor after brain death livers with arterial anatomical variations reconstructed while on NMP were included. All patients survived transplantation, spending 1-7 d in intensive care unit and discharged home after 5-15 d. None of the cases developed early allograft dysfunction or any early technical complications. At follow-up, there were no late hepatic artery thrombosis, stenosis, or any other vascular-related complication. Four of 5 patients underwent magnetic resonance cholangiopancreatography at 6 mo with no evidence of ischemic cholangiopathy.

Conclusions

The case series described above suggests that ex vivo arterial reconstruction surgery on liver grafts while on board the NMP device is feasible, safe, and effective.

Item Type: Article
Subjects: WI Digestive system. Gastroenterology
Divisions: Planned IP Care > Gastroentrology
Related URLs:
Depositing User: Mrs Yolande Brookes
Date Deposited: 09 Oct 2020 17:43
Last Modified: 09 Oct 2020 17:43
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3537

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