Transplantation of discarded livers following viability testing with normothermic machine perfusion.
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Date
2020-06-16ICR Author
Author
Mergental, H
Laing, RW
Kirkham, AJ
Perera, MTPR
Boteon, YL
Attard, J
Barton, D
Curbishley, S
Wilkhu, M
Neil, DAH
Hübscher, SG
Muiesan, P
Isaac, JR
Roberts, KJ
Abradelo, M
Schlegel, A
Ferguson, J
Cilliers, H
Bion, J
Adams, DH
Morris, C
Friend, PJ
Yap, C
Afford, SC
Mirza, DF
Type
Journal Article
Metadata
Show full item recordAbstract
There is a limited access to liver transplantation, however, many organs are discarded based on subjective assessment only. Here we report the VITTAL clinical trial (ClinicalTrials.gov number NCT02740608) outcomes, using normothermic machine perfusion (NMP) to objectively assess livers discarded by all UK centres meeting specific high-risk criteria. Thirty-one livers were enroled and assessed by viability criteria based on the lactate clearance to levels ≤2.5 mmol/L within 4 h. The viability was achieved by 22 (71%) organs, that were transplanted after a median preservation time of 18 h, with 100% 90-day survival. During the median follow up of 542 days, 4 (18%) patients developed biliary strictures requiring re-transplantation. This trial demonstrates that viability testing with NMP is feasible and in this study enabled successful transplantation of 71% of discarded livers, with 100% 90-day patient and graft survival; it does not seem to prevent non-anastomotic biliary strictures in livers donated after circulatory death with prolonged warm ischaemia.
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Subject
Liver
Humans
Liver Function Tests
Organ Preservation
Tissue and Organ Harvesting
Liver Transplantation
Survival Analysis
Prospective Studies
Perfusion
Temperature
Graft Survival
Time Factors
Aged
Middle Aged
Tissue Donors
Female
Male
Non-Randomized Controlled Trials as Topic
Research team
Clinical Trials & Statistics Unit
Language
eng
Date accepted
2020-04-17
License start date
2020-06-16
Citation
Nature communications, 2020, 11 (1), pp. 2939 - ?
Publisher
NATURE PORTFOLIO