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Hypothermic oxygenated machine perfusion reduces bile duct reperfusion injury after transplantation of donation after circulatory death livers.
- Source :
-
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society [Liver Transpl] 2018 May; Vol. 24 (5), pp. 655-664. Date of Electronic Publication: 2018 Apr 06. - Publication Year :
- 2018
-
Abstract
- Dual hypothermic oxygenated machine perfusion (DHOPE) of the liver has been advocated as a method to reduce ischemia/reperfusion injury (IRI). This study aimed to determine whether DHOPE reduces IRI of the bile ducts in donation after circulatory death (DCD) liver transplantation. In a recently performed phase 1 trial, 10 DCD livers were preserved with DHOPE after static cold storage (SCS; www.trialregister.nl NTR4493). Bile duct biopsies were obtained at the end of SCS (before DHOPE; baseline) and after graft reperfusion in the recipient. Histological severity of biliary injury was graded according to an established semiquantitative grading system. Twenty liver transplantations using DCD livers not preserved with DHOPE served as controls. Baseline characteristics and the degree of bile duct injury at baseline (end of SCS) were similar between both groups. In controls, the degree of stroma necrosis (P = 0.002) and injury of the deep peribiliary glands (PBG; P = 0.02) increased after reperfusion compared with baseline. In contrast, in DHOPE-preserved livers, the degree of bile duct injury did not increase after reperfusion. Moreover, there was less injury of deep PBG (P = 0.04) after reperfusion in the DHOPE group compared with controls. In conclusion, this study suggests that DHOPE reduces IRI of bile ducts after DCD liver transplantation. Liver Transplantation 24 655-664 2018 AASLD.<br /> (© 2018 The Authors Liver Transplantation published by Wiley Periodicals, Inc. on behalf of American Association for the Study of Liver Diseases.)
- Subjects :
- Adult
Biopsy
Common Bile Duct pathology
Common Bile Duct Diseases etiology
Common Bile Duct Diseases pathology
Female
Humans
Liver Transplantation adverse effects
Male
Middle Aged
Necrosis
Netherlands
Organ Preservation adverse effects
Organ Preservation instrumentation
Perfusion adverse effects
Perfusion instrumentation
Reperfusion Injury etiology
Reperfusion Injury pathology
Risk Factors
Time Factors
Treatment Outcome
Cold Temperature
Common Bile Duct transplantation
Common Bile Duct Diseases prevention & control
Donor Selection
Liver Transplantation methods
Organ Preservation methods
Perfusion methods
Reperfusion Injury prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1527-6473
- Volume :
- 24
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
- Publication Type :
- Academic Journal
- Accession number :
- 29369470
- Full Text :
- https://doi.org/10.1002/lt.25023