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Liver transplant outcomes after ex vivo machine perfusion: a meta-analysis

Liew, Belle; Nasralla, David; Iype, Satheesh; Pollok, Joerg-Matthias; Davidson, Brian; Raptis, Dimitri A; (2021) Liver transplant outcomes after ex vivo machine perfusion: a meta-analysis. British Journal of Surgery , 108 (12) pp. 1409-1416. 10.1093/bjs/znab364. Green open access

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Abstract

Background: The pressure on liver-transplant programmes has expanded the usage of extended-criteria allografts. Machine perfusion may be better than conventional static cold storage (SCS) in alleviating ischaemia-reperfusion injury in this setting. Recipient outcomes with hypothermic or normothermic machine perfusion were assessed against SCS here. Methods: A search in MEDLINE, EMBASE and Scopus was conducted in February 2021. Primary studies investigating ex vivo machine perfusion were assessed for the following outcomes: morbidity, ICU and hospital stay, graft and patient survival rates and relative costs. Meta-analysis was performed to obtain pooled summary measures. Results: Thirty-four articles involving 1742 patients were included, of which 20 were used for quantitative synthesis. Odds ratios favoured hypothermic machine perfusion (over SCS) with less early allograft dysfunction, ischaemic cholangiopathy, non-anastomotic strictures and graft loss. Hypothermic machine perfusion was associated with a shorter hospital stay and normothermic machine perfusion with reduced graft injury. Two randomized clinical trials found normothermic machine perfusion reduced major complication risks. Conclusion: Machine perfusion assists some outcomes with potential cost savings.

Type: Article
Title: Liver transplant outcomes after ex vivo machine perfusion: a meta-analysis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/bjs/znab364
Publisher version: https://doi.org/10.1093/bjs/znab364
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Surgery, HYPOTHERMIC OXYGENATED PERFUSION, NORMOTHERMIC REGIONAL PERFUSION, COLD-STORAGE, DONOR LIVERS, PRESERVATION, DONATION, ORGAN
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology
URI: https://discovery.ucl.ac.uk/id/eprint/10173335
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