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Controlled Oxygenated Rewarming of Cold Stored Livers Prior to Transplantation : First Clinical Application of a New Concept
- Publication Year :
- 2016
-
Abstract
- Abrupt temperature shift from hypothermia to normothermia incurred on reperfusion of organ grafts has been delineated as a genuine factor contributing to reperfusion injury and graft dysfunction after transplantation.In a first clinical series of 6 patients, cold-stored livers, all allocated by the rescue offer mechanism by Eurotransplant, were subjected to machine-assisted slow controlled oxygenated rewarming (COR) for 90 minutes before engrafting. A historical cohort of 106 patients basically similar in graft (all rescue offer organs) and recipient factors was used for comparison.The clinical benefit of COR was documented by a significant reduction by approximately 50% in peak serum transaminases after transplantation compared to untreated controls (AST 563.5 vs. 1204 U/L, P = 0.023). After 6 months graft survival was 100% in the COR group and 80.9% in the controls (P = 0.24). Respective patient survival was 100% and 84.7% (P = 0.28). Real-time assessment of glucose concentration in the perfusion solution correlated well with postoperative synthetic graft function (r = 0.78; P0.02). All treated recipients had normal liver function after a 6-month follow-up and are well and alive.This first clinical application suggests that controlled graft rewarming after cold storage is a feasible and safe method in clinical praxis and might become an adjunct in organ preservation.
- Subjects :
- Adult
Male
Graft dysfunction
Time Factors
medicine.medical_treatment
Treatment outcome
Medizin
030230 surgery
End Stage Liver Disease
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Liver Function Tests
Risk Factors
medicine
Hepatectomy
Humans
Prospective Studies
Rewarming
Aged
Aged, 80 and over
Transplantation
medicine.diagnostic_test
business.industry
Cold Ischemia
Graft Survival
Hypothermia
Middle Aged
medicine.disease
Liver Transplantation
Oxygen
Perfusion
surgical procedures, operative
Treatment Outcome
Anesthesia
Case-Control Studies
Feasibility Studies
030211 gastroenterology & hepatology
Graft survival
Female
medicine.symptom
business
Liver function tests
Reperfusion injury
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....c1314aaf67456bb97eb5d55bc2441ecc