Frontiers in Surgery (May 2021)
Continuous Normothermic Machine Perfusion for Renovation of Extended Criteria Donor Livers Without Recooling in Liver Transplantation: A Pilot Experience
- Zhitao Chen,
- Zhitao Chen,
- Zhitao Chen,
- Xitao Hong,
- Xitao Hong,
- Xitao Hong,
- Shanzhou Huang,
- Tielong Wang,
- Tielong Wang,
- Tielong Wang,
- Yihao Ma,
- Yihao Ma,
- Yihao Ma,
- Yiwen Guo,
- Yiwen Guo,
- Yiwen Guo,
- Changjun Huang,
- Changjun Huang,
- Changjun Huang,
- Qiang Zhao,
- Qiang Zhao,
- Qiang Zhao,
- Zhiyong Guo,
- Zhiyong Guo,
- Zhiyong Guo,
- Xiaoshun He,
- Xiaoshun He,
- Xiaoshun He,
- Weiqiang Ju,
- Weiqiang Ju,
- Weiqiang Ju,
- Maogen Chen,
- Maogen Chen,
- Maogen Chen
Affiliations
- Zhitao Chen
- Organ Transplant Center, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Zhitao Chen
- Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, China
- Zhitao Chen
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China
- Xitao Hong
- Organ Transplant Center, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Xitao Hong
- Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, China
- Xitao Hong
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China
- Shanzhou Huang
- Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China
- Tielong Wang
- Organ Transplant Center, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Tielong Wang
- Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, China
- Tielong Wang
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China
- Yihao Ma
- Organ Transplant Center, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Yihao Ma
- Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, China
- Yihao Ma
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China
- Yiwen Guo
- Organ Transplant Center, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Yiwen Guo
- Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, China
- Yiwen Guo
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China
- Changjun Huang
- Organ Transplant Center, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Changjun Huang
- Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, China
- Changjun Huang
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China
- Qiang Zhao
- Organ Transplant Center, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Qiang Zhao
- Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, China
- Qiang Zhao
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China
- Zhiyong Guo
- Organ Transplant Center, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Zhiyong Guo
- Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, China
- Zhiyong Guo
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China
- Xiaoshun He
- Organ Transplant Center, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Xiaoshun He
- Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, China
- Xiaoshun He
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China
- Weiqiang Ju
- Organ Transplant Center, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Weiqiang Ju
- Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, China
- Weiqiang Ju
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China
- Maogen Chen
- Organ Transplant Center, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Maogen Chen
- Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, China
- Maogen Chen
- Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China
- DOI
- https://doi.org/10.3389/fsurg.2021.638090
- Journal volume & issue
-
Vol. 8
Abstract
Background: Ischemia injury affects the recovery of liver allograft function. We propose a novel technique aimed at avoiding a second ischemic injury: transplanting an extended criteria donor (ECD) liver directly under normothermic machine perfusion (NMP) without recooling. We studied two cases to evaluate the efficacy and safety of this technique.Methods: The perioperative characteristics and postoperative outcomes of two recipients of ECD livers were analyzed. Both transplantations were performed with continuous normothermic machine perfusion without recooling.Result: In case 1, the cause of donor death was anoxia, and the donor liver had hypernatremia before procurement. The recipient was diagnosed with decompensated cirrhosis. His model for end-stage liver disease (MELD) score was 38. In case 2, the donor liver was from a donor after cardiac death (DCD), and the donor had elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. The recipient was diagnosed with acute hepatic failure. His MELD score was 35. Both donor livers were maintained under NMP and then transplanted without recooling. The peak ALT and AST levels after surgery were 452 and 770 U/L in case 1 and 100 and 592 U/L in case 2. Neither early allograft dysfunction (EAD) nor primary graft non-function (PNF) was present in these two cases.Conclusion: In conclusion, our results demonstrate that continuous NMP without recooling is efficacious and safe for LT with extended criteria donor livers. Further investigations of this technique will be performed to confirm these promising results.
Keywords
- continuous normothermic machine perfusion
- extended criteria donor liver
- early allograft dysfunction
- donor after cardiac death
- allograft
