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Heterogeneous indications and the need for viability assessment: An international survey on the use of machine perfusion in liver transplantation
- Source :
- Transplant International, 46(2), 296-305. Wiley, Artificial Organs, Vol. 46, no.2, p. 296-305 (2022)
- Publication Year :
- 2022
-
Abstract
- Although machine perfusion (MP) is being increasingly adopted in liver transplantation, indications, timing, and modality are debated. To investigate current indications for MP a web-based Google Forms survey was launched in January 2021 and addressed to 127 experts in the field, identified among first and corresponding Authors of MP literature in the last 10years. The survey presented 10 real-life cases of donor-recipient matching, asking whether the liver would be accepted (Q1), whether MP would be used in that particular setting (Q2) and, if so, by which MP modality (Q3) and at what timing during preservation (Q4). Respondents could also comment on each case. The agreement was evaluated using Krippendorff's alpha coefficient. Answers from 39 (30.1%) participants disclosed significant heterogeneity in graft acceptance, MP indications, technique, and timing. Agreement between respondents was generally poor (Q1, α=0.11; Q2, α=0.14; Q3, α=0.12, Q4, α=0.11). Overall, respondents preferred hypothermic MP and an end-ischemic approach in 56.3% and 81.1% of cases, respectively. A total of 18 (46.2%) participants considered only one MP approach, whereas 17 (43.6%) and 3 (7.7%) considered using alternatively 2 or 3 different techniques. Of 38 comments, 17 (44.7%) were about the use of MP for graft viability assessment before implantation. This survey shows considerable variability in MP indications, emphasizing the need to identify scenarios of optimal utilization for each technique. Viability assessment emerges as a fundamental need of transplant professionals when considering the use of MP.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Biomedical Engineering
Medicine (miscellaneous)
Bioengineering
Liver transplantation
normothermic regional perfusion
Biomaterials
ex situ organ perfusion
machine perfusion
organ preservation
viability assessment
Surveys and Questionnaires
Medicine
Humans
Machine perfusion
Graft acceptance
business.industry
Cold Ischemia
Graft Survival
International survey
General Medicine
Organ Preservation
Settore MED/18
Liver Transplantation
Perfusion
Emergency medicine
business
Human
Subjects
Details
- Language :
- English
- ISSN :
- 09340874
- Database :
- OpenAIRE
- Journal :
- Transplant International, 46(2), 296-305. Wiley, Artificial Organs, Vol. 46, no.2, p. 296-305 (2022)
- Accession number :
- edsair.doi.dedup.....1082bf038f5a2e5189be0e760022ae60