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Otto, Gerd; Heise, Michael; Thies, Jochen; Pitton, Michael; Schneider, Jens; Kaiser, Gernot; Neuhaus, Peter; Kollmar, Otto; Barthels, Michael; Geks, Josef; Bechstein, Wolf Otto; Hellinger, Achim; Klempnauer, Jürgen; Padberg, Winfried; Frühauf, Nils; Ebbing, Andre; Mauer, Dietmar; Schneider, Astrid; Kwiecien, Robert; Kronfeld, Kai

Liver Preservation by Aortic Perfusion Alone Compared With Preservation by Aortic Perfusion and Additional Arterial Ex Situ Back-Table Perfusion With Histidine-Tryptophan-Ketoglutarate Solution: A Prospective, Randomized, Controlled, Multicenter Study

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  • Medientyp: E-Artikel
  • Titel: Liver Preservation by Aortic Perfusion Alone Compared With Preservation by Aortic Perfusion and Additional Arterial Ex Situ Back-Table Perfusion With Histidine-Tryptophan-Ketoglutarate Solution: A Prospective, Randomized, Controlled, Multicenter Study
  • Beteiligte: Otto, Gerd; Heise, Michael; Thies, Jochen; Pitton, Michael; Schneider, Jens; Kaiser, Gernot; Neuhaus, Peter; Kollmar, Otto; Barthels, Michael; Geks, Josef; Bechstein, Wolf Otto; Hellinger, Achim; Klempnauer, Jürgen; Padberg, Winfried; Frühauf, Nils; Ebbing, Andre; Mauer, Dietmar; Schneider, Astrid; Kwiecien, Robert; Kronfeld, Kai
  • Erschienen: Ovid Technologies (Wolters Kluwer Health), 2017
  • Erschienen in: Transplantation Direct
  • Sprache: Englisch
  • DOI: 10.1097/txd.0000000000000686
  • ISSN: 2373-8731
  • Schlagwörter: Transplantation
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec> <jats:title>Background</jats:title> <jats:p>Arterial ex situ back-table perfusion (BP<jats:bold>)</jats:bold> reportedly reduces ischemic-type biliary lesion after liver transplantation. We aimed to verify these findings in a prospective investigation.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Our prospective, randomized, controlled, multicenter study involved livers retrieved from patients in 2 German regions, and compared the outcomes of standard aortic perfusion to those of aortic perfusion combined with arterial ex situ BP. The primary endpoint was the incidence of ischemic-type biliary lesions over a follow-up of 2 years after liver transplantation, whereas secondary endpoints included 2-year graft survival, initial graft damage as reflected by transaminase levels, and functional biliary parameters at 6 months after transplantation.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>A total of 75 livers preserved via standard aortic perfusion and 75 preserved via standard aortic perfusion plus arterial BP were treated using a standardized protocol. The incidence of clinically apparent biliary lesions after liver transplantation (n = 9 for both groups; <jats:italic toggle="yes">P</jats:italic> = 0.947), the 2-year graft survival rate (standard aortic perfusion, 74%; standard aortic perfusion plus arterial BP, 68%; <jats:italic toggle="yes">P</jats:italic> = 0.34), and incidence of initial graft injury did not differ between the 2 perfusion modes. Although 33 of the 77 patients with cholangiography workups exhibited injured bile ducts, only 10 had clinical symptoms.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Contrary to previous findings, the present study indicated that additional ex situ BP did not prevent ischemic-type biliary lesions or ischemia-reperfusion injury after liver transplantation. Moreover, there was considerable discrepancy between cholangiography findings regarding bile duct changes and clinically apparent cholangiopathy after transplantation, which should be considered when assessing ischemic-type biliary lesions.</jats:p> </jats:sec>
  • Zugangsstatus: Freier Zugang