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Abdominal normothermic regional perfusion in controlled donation after circulatory determination of death liver transplantation: Outcomes and risk factors for graft loss.
Hessheimer, Amelia J; de la Rosa, Gloria; Gastaca, Mikel; Ruíz, Patricia; Otero, Alejandra; Gómez, Manuel; Alconchel, Felipe; Ramírez, Pablo; Bosca, Andrea; López-Andújar, Rafael; Atutxa, Lánder; Royo-Villanova, Mario; Sánchez, Belinda; Santoyo, Julio; Marín, Luís M; Gómez-Bravo, Miguel Á; Mosteiro, Fernando; Villegas Herrera, María T; Villar Del Moral, Jesús; González-Abos, Carolina; Vidal, Bárbara; López-Domínguez, Josefina; Lladó, Laura; Roldán, José; Justo, Iago; Jiménez, Carlos; López-Monclús, Javier; Sánchez-Turrión, Víctor; Rodríguez-Laíz, Gonzalo; Velasco Sánchez, Enrique; López-Baena, Jose Á; Caralt, Mireia; Charco, Ramón; Tomé, Santiago; Varo, Evaristo; Martí-Cruchaga, Pablo; Rotellar, Fernando; Varona, María A; Barrera, Manuel; Rodríguez-Sanjuan, Juan C; Briceño, Javier; López, Diego; Blanco, Gerardo; Nuño, Javier; Pacheco, David; Coll, Elisabeth; Domínguez-Gil, Beatriz; Fondevila, Constantino.
Affiliation
  • Hessheimer AJ; General & Digestive Surgery, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.
  • de la Rosa G; General & Digestive Surgery Service, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Barcelona, Spain.
  • Gastaca M; IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain.
  • Ruíz P; Organización Nacional de Trasplantes, Madrid, Spain.
  • Otero A; Hospital Universitario Cruces, Bilbao, Spain.
  • Gómez M; Hospital Universitario Cruces, Bilbao, Spain.
  • Alconchel F; Complejo Hospitalario Universitario La Coruña, A Coruna, Spain.
  • Ramírez P; Complejo Hospitalario Universitario La Coruña, A Coruna, Spain.
  • Bosca A; Hospital Clínico Universitario Virgen de la Arrixaca, IMIB, El Palmar, Spain.
  • López-Andújar R; Hospital Clínico Universitario Virgen de la Arrixaca, IMIB, El Palmar, Spain.
  • Atutxa L; Hospital Universitario y Politécnico La Fe, Valencia, Spain.
  • Royo-Villanova M; Hospital Universitario y Politécnico La Fe, Valencia, Spain.
  • Sánchez B; CIBERehd, Instituto de Salud Carlos III, Madrid, Spain.
  • Santoyo J; Hospital Universitario Donostia, San Sebastián, Spain.
  • Marín LM; Hospital Clínico Universitario Virgen de la Arrixaca, IMIB, El Palmar, Spain.
  • Gómez-Bravo MÁ; Hospital Regional Universitario de Málaga, Spain.
  • Mosteiro F; Hospital Regional Universitario de Málaga, Spain.
  • Villegas Herrera MT; Hospital Universitario Virgen del Rocío, Seville, Spain.
  • Villar Del Moral J; Hospital Universitario Virgen del Rocío, Seville, Spain.
  • González-Abos C; Complejo Hospitalario Universitario La Coruña, A Coruna, Spain.
  • Vidal B; Hospital Universitario Virgen de las Nieves, Granada, Spain.
  • López-Domínguez J; Hospital Universitario Virgen de las Nieves, Granada, Spain.
  • Lladó L; General & Digestive Surgery Service, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Barcelona, Spain.
  • Roldán J; Hospital General Universitario de Castellón, Castellón, Spain.
  • Justo I; Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Spain.
  • Jiménez C; Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Spain.
  • López-Monclús J; Hospital Universitario de Navarra, Pamplona, Spain.
  • Sánchez-Turrión V; Hospital Universitario 12 de Octubre, Madrid, Spain.
  • Rodríguez-Laíz G; Hospital Universitario 12 de Octubre, Madrid, Spain.
  • Velasco Sánchez E; Hospital Universitario Puerta de Hierro, Majadahonda, Spain.
  • López-Baena JÁ; Hospital Universitario Puerta de Hierro, Majadahonda, Spain.
  • Caralt M; Department of General & Digestive Surgery, ISABIAL, Hospital General Universitario de Alicante, Alicante, Spain.
  • Charco R; Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  • Tomé S; Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  • Varo E; Hospital Universitario Vall d'Hebrón, Barcelona, Spain.
  • Martí-Cruchaga P; Hospital Universitario Vall d'Hebrón, Barcelona, Spain.
  • Rotellar F; Complejo Hospitalario Universitario Santiago, Santiago de Compostela, Spain.
  • Varona MA; Complejo Hospitalario Universitario Santiago, Santiago de Compostela, Spain.
  • Barrera M; HPB and Liver Transplant Unit, General & Digestive Surgery, Clínica Universitaria de Navarra, Pamplona, Spain.
  • Rodríguez-Sanjuan JC; HPB and Liver Transplant Unit, General & Digestive Surgery, Clínica Universitaria de Navarra, Pamplona, Spain.
  • Briceño J; Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain.
  • López D; Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain.
  • Blanco G; Hospital Universitario Marqués de Valdecilla, Santander, Spain.
  • Nuño J; Hospital Universitario Reina Sofía, Córdoba, Spain.
  • Pacheco D; Hospital Universitario Infanta Cristina, Badajoz, Spain.
  • Coll E; Hospital Universitario Infanta Cristina, Badajoz, Spain.
  • Domínguez-Gil B; Hospital Universitario Ramón y Cajal, Madrid, Spain.
  • Fondevila C; Hospital Universitario Río Hortega, Valladolid, Spain.
Am J Transplant ; 22(4): 1169-1181, 2022 04.
Article in En | MEDLINE | ID: mdl-34856070
Postmortem normothermic regional perfusion (NRP) is a rising preservation strategy in controlled donation after circulatory determination of death (cDCD). Herein, we present results for cDCD liver transplants performed in Spain 2012-2019, with outcomes evaluated through December 31, 2020. Results were analyzed retrospectively and according to recovery technique (abdominal NRP [A-NRP] or standard rapid recovery [SRR]). During the study period, 545 cDCD liver transplants were performed with A-NRP and 258 with SRR. Median donor age was 59 years (interquartile range 49-67 years). Adjusted risk estimates were improved with A-NRP for overall biliary complications (OR 0.300, 95% CI 0.197-0.459, p < .001), ischemic type biliary lesions (OR 0.112, 95% CI 0.042-0.299, p < .001), graft loss (HR 0.371, 95% CI 0.267-0.516, p < .001), and patient death (HR 0.540, 95% CI 0.373-0.781, p = .001). Cold ischemia time (HR 1.004, 95% CI 1.001-1.007, p = .021) and re-transplantation indication (HR 9.552, 95% CI 3.519-25.930, p < .001) were significant independent predictors for graft loss among cDCD livers with A-NRP. While use of A-NRP helps overcome traditional limitations in cDCD liver transplantation, opportunity for improvement remains for cases with prolonged cold ischemia and/or technically complex recipients, indicating a potential role for complimentary ex situ perfusion preservation techniques.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Tissue and Organ Procurement / Liver Transplantation Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Aged / Humans / Middle aged Language: En Journal: Am J Transplant Year: 2022 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Tissue and Organ Procurement / Liver Transplantation Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Aged / Humans / Middle aged Language: En Journal: Am J Transplant Year: 2022 Document type: Article