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Your search keyword '"Mergental, Hynek"' showing total 219 results
Start Over Author "Mergental, Hynek" Publication Type Academic Journals
219 results on '"Mergental, Hynek"'

1. Defatting of donor transplant livers during normothermic perfusion—a randomised clinical trial: study protocol for the DeFat study

Author

Abbas, Syed Hussain, Ceresa, Carlo D. L., Hodson, Leanne, Nasralla, David, Watson, Christopher J. E., Mergental, Hynek, Coussios, Constantin, Kaloyirou, Fotini, Brusby, Kerrie, Mora, Ana, Thomas, Helen, Kounali, Daphne, Keen, Katie, Pollok, Joerg-Matthias, Gaurav, Rohit, Iype, Satheesh, Jassem, Wayel, Perera, M. Thamara PR, Hakeem, Abdul Rahman, Knight, Simon, and Friend, Peter J.

Published
2024
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8. Discarded livers tested by normothermic machine perfusion in the VITTAL trial: Secondary end points and 5-year outcomes.

Author

Mergental, Hynek, Laing, Richard W., Kirkham, Amanda J., Clarke, George, Boteon, Yuri L., Barton, Darren, Neil, Desley A. H., Isaac, John R., Roberts, Keith J., Abradelo, Manuel, Schlegel, Andrea, Dasari, Bobby V. M., Ferguson, James W., Cilliers, Hentie, Morris, Chris, Friend, Peter J., Yap, Christina, Afford, Simon C., Perera, M. Thamara P. R., and Mirza, Darius F.

Published
2024
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10. Transplantation of discarded livers following viability testing with normothermic machine perfusion

Author

Mergental, Hynek, Laing, Richard W., Kirkham, Amanda J., Perera, M. Thamara P. R., Boteon, Yuri L., Attard, Joseph, Barton, Darren, Curbishley, Stuart, Wilkhu, Manpreet, Neil, Desley A. H., Hübscher, Stefan G., Muiesan, Paolo, Isaac, John R., Roberts, Keith J., Abradelo, Manuel, Schlegel, Andrea, Ferguson, James, Cilliers, Hentie, Bion, Julian, Adams, David H., Morris, Chris, Friend, Peter J., Yap, Christina, Afford, Simon C., and Mirza, Darius F.

Published
2020
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12. NAPLES STUDY (NORMOTHERMIC MACHINE PERFUSION OF THE LIVER TO ENABLE THE SICKEST FIRST): PRELIMINARY RESULTS

Author

Lembach, Hanns, Mckay, Siobhan, Hann, Angus, Carvalheiro, Amanda, Boteon, Youri, Alzoubi, Mohammad, Kadam, Prashant, Dissanayake, Buddika, Bartlett, David, Armstrong, Matthew, Rajoriya, Neil, Neil, Desley, Brown, Rachel, Murphy, Nick, Abradelo, Manuel, Roberts, Keith, Schlegel, Andrea, Mergental, Hynek, Mirza, Darius, Muiesan, Paolo, Isaac, John, and Perera, Thamara

Published
2020
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14. A randomized trial of normothermic preservation in liver transplantation

Author

Nasralla, David, Coussios, Constantin C., Mergental, Hynek, Akhtar, M. Zeeshan, Butler, Andrew J., Ceresa, Carlo D. L., and Chiocchia, Virginia

Subjects
Liver transplantation -- Methods, Aspartate, Enzymes, Surgery, Organ transplantation, Environmental issues, Science and technology, Zoology and wildlife conservation
Abstract

Liver transplantation is a highly successful treatment, but is severely limited by the shortage in donor organs. However, many potential donor organs cannot be used; this is because sub-optimal livers do not tolerate conventional cold storage and there is no reliable way to assess organ viability preoperatively. Normothermic machine perfusion maintains the liver in a physiological state, avoids cooling and allows recovery and functional testing. Here we show that, in a randomized trial with 220 liver transplantations, compared to conventional static cold storage, normothermic preservation is associated with a 50% lower level of graft injury, measured by hepatocellular enzyme release, despite a 50% lower rate of organ discard and a 54% longer mean preservation time. There was no significant difference in bile duct complications, graft survival or survival of the patient. If translated to clinical practice, these results would have a major impact on liver transplant outcomes and waiting list mortality.Normothermic machine perfusion of the liver improved early graft function, demonstrated by reduced peak serum aspartate transaminase levels and early allograft dysfunction rates, and improved organ utilization and preservation times, although no differences were seen in graft or patient survival., Author(s): David Nasralla [sup.1] , Constantin C. Coussios [sup.2] , Hynek Mergental [sup.3] , M. Zeeshan Akhtar [sup.1] [sup.4] , Andrew J. Butler [sup.5] , Carlo D. L. Ceresa [sup.1] [...]

Published
2018
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27. In situ normothermic regional perfusion versus ex situ normothermic machine perfusion in liver transplantation from donation after circulatory death.

Author

Mohkam, Kayvan, Nasralla, David, Mergental, Hynek, Muller, Xavier, Butler, Andrew, Jassem, Wayel, Imber, Charles, Monbaliu, Diethard, Perera, M. Thamara P. R., Laing, Richard W., García‐Valdecasas, Juan Carlos, Paul, Andreas, Dondero, Federica, Cauchy, François, Savier, Eric, Scatton, Olivier, Robin, Fabien, Sulpice, Laurent, Bucur, Petru, and Salamé, Ephrem

Published
2022
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46. The role of normothermic machine perfusion in liver transplantation.

Author

Martins, Paulo N., Buchwald, Julianna E., Mergental, Hynek, Vargas, Luciano, and Quintini, Cristiano

Subjects
LIVER surgery, CLINICAL trials, LIVER, PRESERVATION of organs, tissues, etc., TREATMENT effectiveness, LIVER transplantation, PERFUSION, TRANSPLANTATION of organs, tissues, etc.
Abstract

To expand the donor pool of suitable organs for transplantation, there is an increased interest in utilizing extended criteria donor grafts (ECD). Ex-situ machine perfusion has shown to be a promising new modality in the organ preservation field to reduce injury and recover ECD liver grafts. Machine perfusion (MP) is considered a significant improvement in the field of transplantation over the past 20 years. Normothermic machine perfusion has entered the clinical arena in the last decade and has shown promising results to improve the quality of marginal organs and to increase the pool of liver grafts. It allows assessment of viability and function of grafts prior to transplantation. In addition, it has the potential to serve as a platform for pharmacologic organ treatment and graft optimization. Machine perfusion moved from the experimental phase to a more mature phase after safety was confirmed by initial clinical trials. Now, it is time to confirm its superiority and cost-effectiveness before a broader clinical use. In this paper we review the history, current status including outcomes of all clinical trials, limitations, and future trends of normothermic machine preservation. [ABSTRACT FROM AUTHOR]

Published
2020
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47. The Delivery of Multipotent Adult Progenitor Cells to Extended Criteria Human Donor Livers Using Normothermic Machine Perfusion.

Author

Laing, Richard W., Stubblefield, Samantha, Wallace, Lorraine, Roobrouck, Valerie D., Bhogal, Ricky H., Schlegel, Andrea, Boteon, Yuri L., Reynolds, Gary M., Ting, Anthony E., Mirza, Darius F., Newsome, Philip N., Mergental, Hynek, and Afford, Simon C.

Subjects
PROGENITOR cells, PERFUSION, MESENCHYMAL stem cells, CELL populations, CELLULAR therapy
Abstract

Background: Pre-clinical research with multi-potent adult progenitor cells (MAPC® cells, Multistem, Athersys Inc., Cleveland, Ohio) suggests their potential as an anti-inflammatory and immunomodulatory therapy in organ transplantation. Normothermic machine perfusion of the liver (NMP-L) has been proposed as a way of introducing therapeutic agents into the donor organ. Delivery of cellular therapy to human donor livers using this technique has not yet been described in the literature. The primary objectives of this study were to develop a technique for delivering cellular therapy to human donor livers using NMP-L and demonstrate engraftment. Methods: Six discarded human livers were perfused for 6 h at 37°C using the Liver Assist (Organ Assist, Groningen). 50 × 106 CMPTX-labeled MAPC cells were infused directly into the right lobe via the hepatic artery (HA, n = 3) or portal vein (PV, n = 3) over 20 min at different time points during the perfusion. Perfusion parameters were recorded and central and peripheral biopsies were taken at multiple time-points from both lobes and subjected to standard histological stains and confocal microscopy. Perfusate was analyzed using a 35-plex multiplex assay and proteomic analysis. Results: There was no detrimental effect on perfusion flow parameters on infusion of MAPC cells by either route. Three out of six livers met established criteria for organ viability. Confocal microscopy demonstrated engraftment of MAPC cells across vascular endothelium when perfused via the artery. 35-plex multiplex analysis of perfusate yielded 13 positive targets, 9 of which appeared to be related to the infusion of MAPC cells (including Interleukin's 1b, 4, 5, 6, 8, 10, MCP-1, GM-CSF, SDF-1a). Proteomic analysis revealed 295 unique proteins in the perfusate from time-points following the infusion of cellular therapy, many of which have strong links to MAPC cells and mesenchymal stem cells in the literature. Functional enrichment analysis demonstrated their immunomodulatory potential. Conclusion: We have demonstrated that cells can be delivered directly to the target organ, prior to host immune cell population exposure and without compromising the perfusion. Transendothelial migration occurs following arterial infusion. MAPC cells appear to secrete a host of soluble factors that would have anti-inflammatory and immunomodulatory benefits in a human model of liver transplantation. [ABSTRACT FROM AUTHOR]

Published
2020
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48. The impact on the bioenergetic status and oxidative-mediated tissue injury of a combined protocol of hypothermic and normothermic machine perfusion using an acellular haemoglobin-based oxygen carrier: The cold-to-warm machine perfusion of the liver.

Author

Boteon, Yuri L., Laing, Richard W., Schlegel, Andrea, Wallace, Lorraine, Smith, Amanda, Attard, Joseph, Bhogal, Ricky H., Reynolds, Gary, PR Perera, M. Thamara, Muiesan, Paolo, Mirza, Darius F., Mergental, Hynek, and Afford, Simon C.

Subjects
VASCULAR resistance, OXYGEN carriers, PERFUSION, TISSUES, ADENOSINE triphosphate, REACTIVE oxygen species
Abstract

The combination of hypothermic and normothermic machine perfusion (HMP+NMP) of the liver provides individual benefits of both techniques, improving the rescue of marginal organs. The aim of this study was to investigate the effect on the bioenergetic status and the oxidative-mediated tissue injury of an uninterrupted combined protocol of HMP+NMP using a single haemoglobin-based oxygen carrier (HBOC)-based perfusate. Ten discarded human donor livers had either 2 hours of dual hypothermic oxygenated perfusion (D-HOPE) with sequential controlled rewarming (COR) and then NMP using the HBOC-based perfusate uninterruptedly (cold-to-warm group); or 2 hours of hypothermic oxygenated perfusion (HOPE) with an oxygen carrier-free perfusate, followed by perfusate exchange and then NMP with an HBOC-based perfusate. Markers of liver function, tissue adenosine triphosphate (ATP) levels and tissue injury were systematically assessed. The hypothermic phase downregulated mitochondrial respiration and increased ATP levels in both groups. The cold-to-warm group presented higher arterial vascular resistance during rewarming/NMP (p = 0.03) with a trend of lower arterial flow (p = 0.09). At the end of NMP tissue expression of markers of reactive oxygen species production, oxidative injury and inflammation were comparable between the groups. The uninterrupted combined protocol of HMP+NMP using an HBOC-based perfusate—cold-to-warm MP—mitigated the oxidative-mediated tissue injury and enhanced hepatic energy stores, similarly to an interrupted combined protocol; however, it simplified the logistics of this combination and may favour its clinical applicability. [ABSTRACT FROM AUTHOR]

Published
2019
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