dc.contributor.author | Mergental, H | |
dc.contributor.author | Laing, RW | |
dc.contributor.author | Kirkham, AJ | |
dc.contributor.author | Clarke, G | |
dc.contributor.author | Boteon, YL | |
dc.contributor.author | Barton, D | |
dc.contributor.author | Neil, DAH | |
dc.contributor.author | Isaac, JR | |
dc.contributor.author | Roberts, KJ | |
dc.contributor.author | Abradelo, M | |
dc.contributor.author | Schlegel, A | |
dc.contributor.author | Dasari, BVM | |
dc.contributor.author | Ferguson, JW | |
dc.contributor.author | Cilliers, H | |
dc.contributor.author | Morris, C | |
dc.contributor.author | Friend, PJ | |
dc.contributor.author | Yap, C | |
dc.contributor.author | Afford, SC | |
dc.contributor.author | Perera, MTPR | |
dc.contributor.author | Mirza, DF | |
dc.coverage.spatial | United States | |
dc.date.accessioned | 2024-01-29T09:48:38Z | |
dc.date.available | 2024-01-29T09:48:38Z | |
dc.date.issued | 2024-01-01 | |
dc.identifier | 01445473-202401000-00007 | |
dc.identifier.citation | Liver Transplantation, 2024, 30 (1), pp. 30 - 45 | |
dc.identifier.issn | 1527-6465 | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/6125 | |
dc.identifier.eissn | 1527-6473 | |
dc.identifier.eissn | 1527-6473 | |
dc.identifier.doi | 10.1097/LVT.0000000000000270 | |
dc.identifier.doi | 10.1097/LVT.0000000000000270 | |
dc.description.abstract | Normothermic machine perfusion (NMP) enables pretransplant assessment of high-risk donor livers. The VITTAL trial demonstrated that 71% of the currently discarded organs could be transplanted with 100% 90-day patient and graft survivals. Here, we report secondary end points and 5-year outcomes of this prospective, open-label, phase 2 adaptive single-arm study. The patient and graft survivals at 60 months were 82% and 72%, respectively. Four patients lost their graft due to nonanastomotic biliary strictures, one caused by hepatic artery thrombosis in a liver donated following brain death, and 3 in elderly livers donated after circulatory death (DCD), which all clinically manifested within 6 months after transplantation. There were no late graft losses for other reasons. All the 4 patients who died during the study follow-up had functioning grafts. Nonanastomotic biliary strictures developed in donated after circulatory death livers that failed to produce bile with pH >7.65 and bicarbonate levels >25 mmol/L. Histological assessment in these livers revealed high bile duct injury scores characterized by arterial medial necrosis. The quality of life at 6 months significantly improved in all but 4 patients suffering from nonanastomotic biliary strictures. This first report of long-term outcomes of high-risk livers assessed by normothermic machine perfusion demonstrated excellent 5-year survival without adverse effects in all organs functioning beyond 1 year (ClinicalTrials.gov number NCT02740608). | |
dc.format | Print-Electronic | |
dc.format.extent | 30 - 45 | |
dc.language | eng | |
dc.language.iso | eng | |
dc.publisher | LIPPINCOTT WILLIAMS & WILKINS | |
dc.relation.ispartof | Liver Transplantation | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.subject | Humans | |
dc.subject | Aged | |
dc.subject | Liver Transplantation | |
dc.subject | Prospective Studies | |
dc.subject | Constriction, Pathologic | |
dc.subject | Quality of Life | |
dc.subject | Liver | |
dc.subject | Perfusion | |
dc.subject | Organ Preservation | |
dc.title | Discarded livers tested by normothermic machine perfusion in the VITTAL trial: Secondary end points and 5-year outcomes. | |
dc.type | Journal Article | |
dcterms.dateAccepted | 2023-08-27 | |
dc.date.updated | 2024-01-25T10:26:55Z | |
rioxxterms.version | VoR | |
rioxxterms.versionofrecord | 10.1097/LVT.0000000000000270 | |
rioxxterms.licenseref.startdate | 2024-01-01 | |
rioxxterms.type | Journal Article/Review | |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/38109282 | |
pubs.issue | 1 | |
pubs.organisational-group | ICR | |
pubs.organisational-group | ICR/Primary Group | |
pubs.organisational-group | ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | ICR/Primary Group/ICR Divisions/Clinical Studies | |
pubs.organisational-group | ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical Trials & Statistics Unit | |
pubs.publication-status | Published | |
pubs.publisher-url | http://dx.doi.org/10.1097/lvt.0000000000000270 | |
pubs.volume | 30 | |
icr.researchteam | Clin Trials & Stats Unit | |
dc.contributor.icrauthor | Yap, Christina | |
icr.provenance | Deposited by Ms Jessica Perry (impersonating Prof Christina Yap) on 2024-01-25. Deposit type is initial. No. of files: 1. Files: discarded_livers_tested_by_normothermic_machine.7.pdf | |