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158 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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7. 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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8. Machine perfusion and the prevention of ischemic type biliary lesions following liver transplant: What is the evidence?

Author

Durán, Manuel, primary, Calleja, Rafael, additional, Hann, Angus, additional, Clarke, George, additional, Ciria, Ruben, additional, Nutu, Anisa, additional, Sanabria-Mateos, Rebeca, additional, Ayllón, María Dolores, additional, López-Cillero, Pedro, additional, Mergental, Hynek, additional, Briceño, Javier, additional, and Perera, M Thamara P R, additional

Published
2023
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10. 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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22. Ex situ Normothermic Split Liver Machine Perfusion: Protocol for Robust Comparative Controls in Liver Function Assessment Suitable for Evaluation of Novel Therapeutic Interventions in the Pre-clinical Setting

Author

Attard, Joseph A., primary, Osei-Bordom, Daniel-Clement, additional, Boteon, Yuri, additional, Wallace, Lorraine, additional, Ronca, Vincenzo, additional, Reynolds, Gary, additional, Perera, M. T. P. R., additional, Oo, Ye Htun, additional, Mergental, Hynek, additional, Mirza, Darius F., additional, and Afford, Simon C., additional

Published
2021
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24. Biliary Strictures Are Associated With Both Early and Late Hepatic Artery Stenosis

Author

Hann, Angus, primary, Seth, Rashmi, additional, Mergental, Hynek, additional, Hartog, Hermien, additional, Alzoubi, Mohammad, additional, Stangou, Arie, additional, El-Sherif, Omar, additional, Ferguson, James, additional, Roberts, Keith, additional, Muiesan, Paolo, additional, Oo, Ye, additional, Issac, John R., additional, Mirza, Darius, additional, and Perera, M. Thamara P.R., additional

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

Author

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

Published
2020
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31. Correction: 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., primary, Laing, Richard W., additional, Schlegel, Andrea, additional, Wallace, Lorraine, additional, Smith, Amanda, additional, Attard, Joseph, additional, Bhogal, Ricky H., additional, Reynolds, Gary, additional, Thamara PR Perera, M., additional, Muiesan, Paolo, additional, Mirza, Darius F., additional, Mergental, Hynek, additional, and Afford, Simon C., additional

Published
2020
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34. 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., primary, Laing, Richard W., additional, Schlegel, Andrea, additional, Wallace, Lorraine, additional, Smith, Amanda, additional, Attard, Joseph, additional, Bhogal, Ricky H., additional, Reynolds, Gary, additional, PR Perera, M. Thamara, additional, Muiesan, Paolo, additional, Mirza, Darius F., additional, Mergental, Hynek, additional, and Afford, Simon C., additional

Published
2019
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37. Manipulation of Lipid Metabolism During Normothermic Machine Perfusion: Effect of Defatting Therapies on Donor Liver Functional Recovery

Author

Boteon, Yuri L., Attard, Joseph, Boteon, Amanda P. C. S., Wallace, Lorraine, Reynolds, Gary, Hubscher, Stefan, Mirza, Darius F., Mergental, Hynek, Bhogal, Ricky H., and Afford, Simon C.

Subjects
Male, Living Donors, Humans, Nicotinamide Phosphoribosyltransferase, Perylene, Pretreatment Assessment and Conditions, Anthracenes, Phenylurea Compounds, Colforsin, Original Articles, Organ Preservation, Middle Aged, Allografts, Lipid Metabolism, Liver Transplantation, Fatty Liver, Perfusion, Butyrates, Pharmaceutical Solutions, Thiazoles, Liver, Reperfusion Injury, Tissue and Organ Harvesting, Feasibility Studies, Original Article, Female
Abstract

Strategies to increase the use of steatotic donor livers are required to tackle the mortality on the transplant waiting list. We aimed to test the efficacy of pharmacological enhancement of the lipid metabolism of human livers during ex situ normothermic machine perfusion to promote defatting and improve the functional recovery of the organs. Because of steatosis, 10 livers were discarded and were allocated either to a defatting group that had the perfusate supplemented with a combination of drugs to enhance lipid metabolism or to a control group that received perfusion fluid with vehicle only. Steatosis was assessed using tissue homogenate and histological analyses. Markers for lipid oxidation and solubilization, oxidative injury, inflammation, and biliary function were evaluated by enzyme‐linked immunosorbent assay, immunohistochemistry, and in‐gel protein detection. Treatment reduced tissue triglycerides by 38% and macrovesicular steatosis by 40% over 6 hours. This effect was driven by increased solubility of the triglycerides (P = 0.04), and mitochondrial oxidation as assessed by increased ketogenesis (P = 0.008) and adenosine triphosphate synthesis (P = 0.01) were associated with increased levels of the enzymes acyl‐coenzyme A oxidase 1, carnitine palmitoyltransferase 1A, and acetyl‐coenzyme A synthetase. Concomitantly, defatted livers exhibited enhanced metabolic functional parameters such as urea production (P = 0.03), lower vascular resistance, lower release of alanine aminotransferase (P = 0.049), and higher bile production (P = 0.008) with a higher bile pH (P = 0.03). The treatment down‐regulated the expression of markers for oxidative injury as well as activation of immune cells (CD14; CD11b) and reduced the release of inflammatory cytokines in the perfusate (tumor necrosis factor α; interleukin 1β). In conclusion, pharmacological enhancement of intracellular lipid metabolism during normothermic machine perfusion decreased the lipid content of human livers within 6 hours. It also improved the intracellular metabolic support to the organs, leading to successful functional recovery and decreased expression of markers of reperfusion injury.

Published
2018

38. Viability testing and transplantation of marginal livers (VITTAL) using normothermic machine perfusion: study protocol for an open-label, non-randomised, prospective, single-arm trial

Author

Laing, Richard W, Mergental, Hynek, Yap, Christina, Kirkham, Amanda, Whilku, Manpreet, Barton, Darren, Curbishley, Stuart, Boteon, Yuri L, Neil, Desley A, Hübscher, Stefan G, Perera, M Thamara P R, Muiesan, Paolo, Isaac, John, Roberts, Keith J, Cilliers, Hentie, Afford, Simon C, and Mirza, Darius F

Subjects
Tissue Survival, Time Factors, Tissue and Organ Procurement, Non-Randomized Controlled Trials as Topic, Organ Preservation, hepatobiliary tumours, hepatobiliary disease, Transplant Recipients, Liver Transplantation, Perfusion, Liver, transplant surgery, hepatology, Practice Guidelines as Topic, Protocol, Feasibility Studies, Humans, Surgery, Prospective Studies
Abstract

Introduction The use of marginal or extended criteria donor livers is increasing. These organs carry a greater risk of initial dysfunction and early failure, as well as inferior long-term outcomes. As such, many are rejected due to a perceived risk of use and use varies widely between centres. Ex situ normothermic machine perfusion of the liver (NMP-L) may enable the safe transplantation of organs that meet defined objective criteria denoting their high-risk status and are currently being declined for use by all the UK transplant centres. Methods and analysis Viability testing and transplantation of marginal livers is an open-label, non-randomised, prospective, single-arm trial designed to determine whether currently unused donor livers can be salvaged and safely transplanted with equivalent outcomes in terms of patient survival. The procured rejected livers must meet predefined criteria that objectively denote their marginal condition. The liver is subjected to NMP-L following a period of static cold storage. Organs metabolising lactate to ≤2.5 mmol/L within 4 hours of the perfusion commencing in combination with two or more of the following parameters—bile production, metabolism of glucose, a hepatic arterial flow rate ≥150 mL/min and a portal venous flow rate ≥500 mL/min, a pH ≥7.30 and/or maintain a homogeneous perfusion—will be considered viable and transplanted into a suitable consented recipient. The coprimary outcome measures are the success rate of NMP-L to produce a transplantable organ and 90-day patient post-transplant survival. Ethics and dissemination The protocol was approved by the National Research Ethics Service (London—Dulwich Research Ethics Committee, 16/LO/1056), the Medicines and Healthcare Products Regulatory Agency and is endorsed by the National Health Service Blood and Transplant Research, Innovation and Novel Technologies Advisory Group. The findings of this trial will be disseminated through national and international presentations and peer-reviewed publications. Trial registration number NCT02740608; Pre-results.

Published
2017

43. Long-term follow-up after endovascular treatment of hepatic venous outflow obstruction following liver transplantation

Author

Pitchaimuthu, Maheswaran, primary, Roll, Garrett R., additional, Zia, Zergham, additional, Olliff, Simon, additional, Mehrzad, Homoyoon, additional, Hodson, James, additional, Gunson, Bridget K., additional, Perera, M. Thamara P. R., additional, Isaac, John R., additional, Muiesan, Paolo, additional, Mirza, Darius F., additional, and Mergental, Hynek, additional

Published
2016
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44. Comparing clinical presentations, treatments and outcomes of hepatocellular carcinoma due to hepatitis C and non-alcoholic fatty liver disease

Author

Than, Nwe Ni, primary, Ghazanfar, Anwar, additional, Hodson, James, additional, Tehami, Nadeem, additional, Coldham, Chris, additional, Mergental, Hynek, additional, Manas, Derek, additional, Shah, Tahir, additional, Newsome, Philip N, additional, Reeves, Helen, additional, and Shetty, Shishir, additional

Published
2016
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45. Normothermic Machine Perfusion of Deceased Donor Liver Grafts Is Associated With Improved Postreperfusion Hemodynamics

Author

Angelico, Roberta, primary, Perera, M. Thamara P. R, additional, Ravikumar, Reena, additional, Holroyd, David, additional, Coussios, Constantin, additional, Mergental, Hynek, additional, Isaac, John R., additional, Iqbal, Asim, additional, Cilliers, Hentie, additional, Muiesan, Paolo, additional, Friend, Peter J., additional, and Mirza, Darius F., additional

Published
2016
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46. First human liver transplantation using a marginal allograft resuscitated by normothermic machine perfusion

Author

Perera, Thamara, primary, Mergental, Hynek, additional, Stephenson, Barney, additional, Roll, Garrett R., additional, Cilliers, Hentie, additional, Liang, Richard, additional, Angelico, Roberta, additional, Hubscher, Stefan, additional, Neil, Desley A., additional, Reynolds, Gary, additional, Isaac, John, additional, Adams, David A., additional, Afford, Simon, additional, Mirza, Darius F., additional, and Muiesan, Paolo, additional

Published
2015
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47. Vasculobiliary complications following adult right lobe split liver transplantation from the perspective of reconstruction techniques

Author

Mabrouk Mourad, Moustafa, primary, Liossis, Christos, additional, Kumar, Senthil, additional, Gunson, Bridget K., additional, Mergental, Hynek, additional, Isaac, John, additional, Bramhall, Simon R., additional, Muiesan, Paolo, additional, Mirza, Darius F., additional, and Thamara P. R. Perera, M., additional

Published
2014
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48. Increasing the Donor Pool: Consideration of Prehospital Cardiac Arrest in Controlled Donation After Circulatory Death for Liver Transplantation

Author

Elaffandi, Ahmed H., primary, Bonney, Glenn K., additional, Gunson, Bridget, additional, Scalera, Irene, additional, Mergental, Hynek, additional, Isaac, John R., additional, Bramhall, Simon R., additional, Mirza, Darius F., additional, P.R. Perera, M. Thamara, additional, and Muiesan, Paolo, additional

Published
2013
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49. Is Hepatocyte Necrosis a Good Marker of Donor Liver Viability During Machine Perfusion?

Author

Neil, Desley A.H., Mergental, Hynek, Hann, Angus, Laing, Richard W, Hartog, Hermien, Mirza, Darius F, and Perera, M. Thamara P.R.

Subjects
LIVER, PERFUSION, NECROSIS, MACHINERY
Abstract

They use histological assessment of hepatocyte necrosis as the basis of determining whether a liver is nonviable and conclude that lactate clearance during NMP is not able to differentiate between viable and nonviable livers. In conclusion, significant hepatocyte necrosis in DBD grafts can be successfully transplanted following NMP, indicating that hepatocyte necrosis I per se i is not a reliable surrogate for viability of a donor liver. [Extracted from the article]

Published
2022
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