Journal Article

Hypothermic Oxygenated New Machine Perfusion System in Liver and Kidney Transplantation of Extended Criteria Donors:First Italian Clinical Trial

De Pace, Vanessa, Donadei, Chiara, Angeletti, Andrea, Del Gaudio, Massimo, Ranieri, Vito Marco, Maroni, Lorenzo, Baldassarre, Maurizio, Pasquinelli, Gianandrea, Vasuri, Francesco, Fallani, Guido, Cescon, Matteo, Bertuzzo, Valentina Rosa, Siniscalchi, Antonio, Caraceni, Paolo, Germinario, Giuliana, Pinna, Antonio Daniele, Ravaioli, Matteo, D’Errico, Antonietta, La Manna, Gaetano, Malvi, Deborah, Odaldi, Federica, Comai, Giorgia, Morelli, Maria Cristina

2020

Overview

With the aim to explore innovative tools for organ preservation, especially in marginal organs, we hereby describe a clinical trial of ex-vivo hypothermic oxygenated perfusion (HOPE) in the field of liver (LT) and kidney transplantation (KT) from Extended Criteria Donors (ECD) after brain death. A matched-case analysis of donor and recipient variables was developed: 10 HOPE-ECD livers and kidneys (HOPE-L and HOPE-K) were matched 1:3 with livers and kidneys preserved with static cold storage (SCS-L and SCS-K). HOPE and SCS groups resulted with similar basal characteristics, both for recipients and donors. Cumulative liver and kidney graft dysfunction were 10% (HOPE L-K) vs . 31.7%, in SCS group ( p  =  0.05 ). Primary non-function was 3.3% for SCS-L vs . 0% for HOPE-L. No primary non-function was reported in HOPE-K and SCS-K. Median peak aspartate aminotransferase within 7-days post-LT was significantly higher in SCS-L when compared to HOPE-L (637 vs .344 U/L, p  =  0.007 ). Graft survival at 1-year post-transplant was 93.3% for SCS-L vs. 100% of HOPE-L and 90% for SCS-K vs. 100% of HOPE-K. Clinical outcomes support our hypothesis of machine perfusion being a safe and effective system to reduce ischemic preservation injuries in KT and in LT.

• Publisher: Nature Publishing Group UK,Nature Publishing Group
• Subject: 13 / 14 / 692/308/2779 / 692/4022/272 / 692/699/1585 / Aged / Aspartate aminotransferase / Aspartate Aminotransferases - metabolism / Brain injury / Clinical trials / Cold Temperature / Cryopreservation / Donors / Female / Graft Survival / Humanities and Social Sciences / Humans / Infusion Pumps - adverse effects / Infusion Pumps - standards / Ischemia / Kidney - metabolism / Kidney transplantation / Kidney Transplantation - instrumentation / Kidney Transplantation - methods / Kidney transplants / Kidneys / Liver - metabolism / Liver diseases / Liver transplantation / Liver Transplantation - instrumentation / Liver Transplantation - methods / Male / Middle Aged / multidisciplinary / Organ Preservation - instrumentation / Organ Preservation - methods / Oxygenators, Membrane - adverse effects / Oxygenators, Membrane - standards / Perfusion / Perfusion - instrumentation / Perfusion - methods / Preservation / Science / Science (multidisciplinary) / Tissue Donors / Transplants & implants