Hypothermic machine preservation in human liver transplantation: The first clinical series

J. V. Guarrera, S. D. Henry, B. Samstein, R. Odeh-Ramadan, Milan Kinkhabwala, M. J. Goldstein, L. E. Ratner, J. F. Renz, H. T. Lee, R. S. Brown, J. C. Emond

Research output: Contribution to journalArticle

275 Citations (Scopus)

Abstract

Hypothermic machine perfusion (HMP) is widely used to preserve kidneys for transplantation with improved results over cold storage (CS). To date, successful transplantation of livers preserved with HMP has been reported only in animal models. In this, the first prospective liver HMP study, 20 adults received HMP-preserved livers and were compared to a matched group transplanted with CS livers. HMP was performed for 3-7 h using centrifugal perfusion with Vasosol® solution at 4-6°C. There were no cases of primary nonfunction in either group. Early allograft dysfunction rates were 5% in the HMP group versus 25% in controls (p = 0.08). At 12 months, there were two deaths in each group, all unrelated to preservation or graft function. There were no vascular complications in HMP livers. Two biliary complications were observed in HMP livers compared with four in the CS group. Serum injury markers were significantly lower in the HMP group. Mean hospital stay was shorter in the HMP group (10.9 ± 4.7 days vs. 15.3 ± 4.9 days in the CS group, p = 0.006). HMP of donor livers provided safe and reliable preservation in this pilot case-controlled series. Further multicenter HMP trials are now warranted.

Original languageEnglish (US)
Pages (from-to)372-381
Number of pages10
JournalAmerican Journal of Transplantation
Volume10
Issue number2
DOIs
StatePublished - Feb 2010

Fingerprint

Liver Transplantation
Perfusion
Liver
Kidney Transplantation
Allografts
Blood Vessels
Length of Stay
Research Design
Animal Models
Biomarkers
Transplants

Keywords

  • Clinical liver transplantation
  • Human
  • Hypothermic machine perfusion
  • Machine perfusion
  • Machine preservation
  • Organ preservation
  • Outcomes

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

Cite this

Hypothermic machine preservation in human liver transplantation : The first clinical series. / Guarrera, J. V.; Henry, S. D.; Samstein, B.; Odeh-Ramadan, R.; Kinkhabwala, Milan; Goldstein, M. J.; Ratner, L. E.; Renz, J. F.; Lee, H. T.; Brown, R. S.; Emond, J. C.

In: American Journal of Transplantation, Vol. 10, No. 2, 02.2010, p. 372-381.

Research output: Contribution to journalArticle

Guarrera, JV, Henry, SD, Samstein, B, Odeh-Ramadan, R, Kinkhabwala, M, Goldstein, MJ, Ratner, LE, Renz, JF, Lee, HT, Brown, RS & Emond, JC 2010, 'Hypothermic machine preservation in human liver transplantation: The first clinical series', American Journal of Transplantation, vol. 10, no. 2, pp. 372-381. https://doi.org/10.1111/j.1600-6143.2009.02932.x
Guarrera, J. V. ; Henry, S. D. ; Samstein, B. ; Odeh-Ramadan, R. ; Kinkhabwala, Milan ; Goldstein, M. J. ; Ratner, L. E. ; Renz, J. F. ; Lee, H. T. ; Brown, R. S. ; Emond, J. C. / Hypothermic machine preservation in human liver transplantation : The first clinical series. In: American Journal of Transplantation. 2010 ; Vol. 10, No. 2. pp. 372-381.
@article{1ac0b71f23984237aeef60114acc5098,
title = "Hypothermic machine preservation in human liver transplantation: The first clinical series",
abstract = "Hypothermic machine perfusion (HMP) is widely used to preserve kidneys for transplantation with improved results over cold storage (CS). To date, successful transplantation of livers preserved with HMP has been reported only in animal models. In this, the first prospective liver HMP study, 20 adults received HMP-preserved livers and were compared to a matched group transplanted with CS livers. HMP was performed for 3-7 h using centrifugal perfusion with Vasosol{\circledR} solution at 4-6°C. There were no cases of primary nonfunction in either group. Early allograft dysfunction rates were 5{\%} in the HMP group versus 25{\%} in controls (p = 0.08). At 12 months, there were two deaths in each group, all unrelated to preservation or graft function. There were no vascular complications in HMP livers. Two biliary complications were observed in HMP livers compared with four in the CS group. Serum injury markers were significantly lower in the HMP group. Mean hospital stay was shorter in the HMP group (10.9 ± 4.7 days vs. 15.3 ± 4.9 days in the CS group, p = 0.006). HMP of donor livers provided safe and reliable preservation in this pilot case-controlled series. Further multicenter HMP trials are now warranted.",
keywords = "Clinical liver transplantation, Human, Hypothermic machine perfusion, Machine perfusion, Machine preservation, Organ preservation, Outcomes",
author = "Guarrera, {J. V.} and Henry, {S. D.} and B. Samstein and R. Odeh-Ramadan and Milan Kinkhabwala and Goldstein, {M. J.} and Ratner, {L. E.} and Renz, {J. F.} and Lee, {H. T.} and Brown, {R. S.} and Emond, {J. C.}",
year = "2010",
month = "2",
doi = "10.1111/j.1600-6143.2009.02932.x",
language = "English (US)",
volume = "10",
pages = "372--381",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Hypothermic machine preservation in human liver transplantation

T2 - The first clinical series

AU - Guarrera, J. V.

AU - Henry, S. D.

AU - Samstein, B.

AU - Odeh-Ramadan, R.

AU - Kinkhabwala, Milan

AU - Goldstein, M. J.

AU - Ratner, L. E.

AU - Renz, J. F.

AU - Lee, H. T.

AU - Brown, R. S.

AU - Emond, J. C.

PY - 2010/2

Y1 - 2010/2

N2 - Hypothermic machine perfusion (HMP) is widely used to preserve kidneys for transplantation with improved results over cold storage (CS). To date, successful transplantation of livers preserved with HMP has been reported only in animal models. In this, the first prospective liver HMP study, 20 adults received HMP-preserved livers and were compared to a matched group transplanted with CS livers. HMP was performed for 3-7 h using centrifugal perfusion with Vasosol® solution at 4-6°C. There were no cases of primary nonfunction in either group. Early allograft dysfunction rates were 5% in the HMP group versus 25% in controls (p = 0.08). At 12 months, there were two deaths in each group, all unrelated to preservation or graft function. There were no vascular complications in HMP livers. Two biliary complications were observed in HMP livers compared with four in the CS group. Serum injury markers were significantly lower in the HMP group. Mean hospital stay was shorter in the HMP group (10.9 ± 4.7 days vs. 15.3 ± 4.9 days in the CS group, p = 0.006). HMP of donor livers provided safe and reliable preservation in this pilot case-controlled series. Further multicenter HMP trials are now warranted.

AB - Hypothermic machine perfusion (HMP) is widely used to preserve kidneys for transplantation with improved results over cold storage (CS). To date, successful transplantation of livers preserved with HMP has been reported only in animal models. In this, the first prospective liver HMP study, 20 adults received HMP-preserved livers and were compared to a matched group transplanted with CS livers. HMP was performed for 3-7 h using centrifugal perfusion with Vasosol® solution at 4-6°C. There were no cases of primary nonfunction in either group. Early allograft dysfunction rates were 5% in the HMP group versus 25% in controls (p = 0.08). At 12 months, there were two deaths in each group, all unrelated to preservation or graft function. There were no vascular complications in HMP livers. Two biliary complications were observed in HMP livers compared with four in the CS group. Serum injury markers were significantly lower in the HMP group. Mean hospital stay was shorter in the HMP group (10.9 ± 4.7 days vs. 15.3 ± 4.9 days in the CS group, p = 0.006). HMP of donor livers provided safe and reliable preservation in this pilot case-controlled series. Further multicenter HMP trials are now warranted.

KW - Clinical liver transplantation

KW - Human

KW - Hypothermic machine perfusion

KW - Machine perfusion

KW - Machine preservation

KW - Organ preservation

KW - Outcomes

UR - http://www.scopus.com/inward/record.url?scp=75149167856&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=75149167856&partnerID=8YFLogxK

U2 - 10.1111/j.1600-6143.2009.02932.x

DO - 10.1111/j.1600-6143.2009.02932.x

M3 - Article

C2 - 19958323

AN - SCOPUS:75149167856

VL - 10

SP - 372

EP - 381

JO - American Journal of Transplantation

JF - American Journal of Transplantation

SN - 1600-6135

IS - 2

ER -