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Normothermic regional perfusion vs. super-rapid recovery in controlled donation after circulatory death liver transplantation

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dc.contributor.authorHessheimer, Amelia J,
dc.contributor.authorColl, Elisabeth
dc.contributor.authorTorres, Ferrán
dc.contributor.authorRamírez, Pablo
dc.contributor.authorFondevilla, Constantino
dc.contributor.departmentCirugía, Pediatría y Obstetricia y Ginecología
dc.date.accessioned2025-01-30T15:48:11Z
dc.date.available2025-01-30T15:48:11Z
dc.date.created2019-04
dc.description© 2018 European Association for the Study of the Liver This document is the published version of a published work that appeared in final form Journal of Hepatology . To access the final edited and published work see: https://doi.org/10.1016/j.jhep.2018.12.013
dc.description.abstractBackground & aims: Although there is increasing interest in its use, definitive evidence demonstrating a benefit for postmortem normothermic regional perfusion (NRP) in controlled donation after circulatory death (cDCD) liver transplantation is lacking. The aim of this study was to compare results of cDCD liver transplants performed with postmortem NRP vs. super-rapid recovery (SRR), the current standard for cDCD. Methods: This was an observational cohort study including all cDCD liver transplants performed in Spain between June 2012 and December 2016, with follow-up ending in December 2017. Each donor hospital determined whether organ recovery was performed using NRP or SRR. The propensity scores technique based on the inverse probability of treatment weighting (IPTW) was used to balance covariates across study groups; logistic and Cox regression models were used for binary and time-to-event outcomes. Results: During the study period, there were 95 cDCD liver transplants performed with postmortem NRP and 117 with SRR. The median donor age was 56 years (interquartile range 45-65 years). After IPTW analysis, baseline covariates were balanced, with all absolute standardised differences <0.15. IPTW-adjusted risks were significantly improved among NRP livers for overall biliary complications (odds ratio 0.14; 95% CI 0.06-0.35, p <0.001), ischaemic type biliary lesions (odds ratio 0.11; 95% CI 0.02-0.57; p = 0.008), and graft loss (hazard ratio 0.39; 95% CI 0.20-0.78; p = 0.008). Conclusions: The use of postmortem NRP in cDCD liver transplantation appears to reduce postoperative biliary complications, ischaemic type biliary lesions and graft loss, and allows for the transplantation of livers even from cDCD donors of advanced age.es
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dc.format.extent9es
dc.identifier.citationJ Hepatol. 2019 Apr 70(4):658-665
dc.identifier.doihttps://doi.org/10.1016/j.jhep.2018.12.013
dc.identifier.issnPrint.. 0168-8278
dc.identifier.issnElectronic.:1600-0641
dc.identifier.urihttp://hdl.handle.net/10201/149785
dc.languageenges
dc.publisherElsevier
dc.relationSin financiación externa a la Universidad.es
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/pii/S0168827818326321?via%3Dihub
dc.rights.accessRightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectDonation after circulatory deathes
dc.subjectIschaemic type biliary lesions
dc.subjectLiver transplantation
dc.subjectMarginal donor
dc.subjectNon-anastomotic biliary strictures
dc.subjectNormothermic regional perfusion
dc.subject.otherCDU::6 - Ciencias aplicadas::61 - Medicina::617 - Cirugía. Ortopedia. Oftalmologíaes
dc.titleNormothermic regional perfusion vs. super-rapid recovery in controlled donation after circulatory death liver transplantationes
dc.typeinfo:eu-repo/semantics/articlees
dspace.entity.typePublicationes
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