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The Effect of Continuous Liver Normothermic Machine Perfusion on the Severity of Histological Bile Duct Injury

Static Cold Storage (SCS) injures the bile duct, while the effect of Normothermic Machine Perfusion (NMP) is unknown. In a sub-study of the COPE trial on liver NMP, we investigated the impact of preservation type on histological bile duct injury score (BDIS). Transplants with at least one bile duct...

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Autores principales: Gilbo, Nicholas, Neil, Desley, Brais, Rebecca, Fieuws, Steffen, Lo Faro, Letizia, Friend, Peter, Ploeg, Rutger, Monbaliu, Diethard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505658/
https://www.ncbi.nlm.nih.gov/pubmed/37727383
http://dx.doi.org/10.3389/ti.2023.11645
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author Gilbo, Nicholas
Neil, Desley
Brais, Rebecca
Fieuws, Steffen
Lo Faro, Letizia
Friend, Peter
Ploeg, Rutger
Monbaliu, Diethard
author_facet Gilbo, Nicholas
Neil, Desley
Brais, Rebecca
Fieuws, Steffen
Lo Faro, Letizia
Friend, Peter
Ploeg, Rutger
Monbaliu, Diethard
author_sort Gilbo, Nicholas
collection PubMed
description Static Cold Storage (SCS) injures the bile duct, while the effect of Normothermic Machine Perfusion (NMP) is unknown. In a sub-study of the COPE trial on liver NMP, we investigated the impact of preservation type on histological bile duct injury score (BDIS). Transplants with at least one bile duct biopsy, either at end of preservation or 1 h post-reperfusion, were considered. BDIS was determined by assessing peribiliary glands injury, stromal and mural loss, haemorrhage, and thrombosis. A bivariate linear model compared BDIS (estimate, CI) between groups. Sixty-five transplants and 85 biopsies were analysed. Twenty-three grafts were preserved with SCS and 42 with NMP, with comparable baseline characteristics except for a shorter cold ischemic time in NMP. The BDIS increased over time regardless of preservation type (p = 0.04). The BDIS estimate was higher in NMP [8.02 (7.40–8.65)] than in SCS [5.39 (4.52–6.26), p < 0.0001] regardless of time. One patient in each group developed ischemic cholangiopathy, with a BDIS of 6 for the NMP-preserved liver. In six other NMP grafts, BDIS ranged 7–12 without development of ischemic cholangiopathy. In conclusion, BDIS increases over time, and the higher BDIS in NMP did not increase ischemic cholangiopathy. Thus, BDIS may overestimate this risk after liver NMP.
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spelling pubmed-105056582023-09-19 The Effect of Continuous Liver Normothermic Machine Perfusion on the Severity of Histological Bile Duct Injury Gilbo, Nicholas Neil, Desley Brais, Rebecca Fieuws, Steffen Lo Faro, Letizia Friend, Peter Ploeg, Rutger Monbaliu, Diethard Transpl Int Health Archive Static Cold Storage (SCS) injures the bile duct, while the effect of Normothermic Machine Perfusion (NMP) is unknown. In a sub-study of the COPE trial on liver NMP, we investigated the impact of preservation type on histological bile duct injury score (BDIS). Transplants with at least one bile duct biopsy, either at end of preservation or 1 h post-reperfusion, were considered. BDIS was determined by assessing peribiliary glands injury, stromal and mural loss, haemorrhage, and thrombosis. A bivariate linear model compared BDIS (estimate, CI) between groups. Sixty-five transplants and 85 biopsies were analysed. Twenty-three grafts were preserved with SCS and 42 with NMP, with comparable baseline characteristics except for a shorter cold ischemic time in NMP. The BDIS increased over time regardless of preservation type (p = 0.04). The BDIS estimate was higher in NMP [8.02 (7.40–8.65)] than in SCS [5.39 (4.52–6.26), p < 0.0001] regardless of time. One patient in each group developed ischemic cholangiopathy, with a BDIS of 6 for the NMP-preserved liver. In six other NMP grafts, BDIS ranged 7–12 without development of ischemic cholangiopathy. In conclusion, BDIS increases over time, and the higher BDIS in NMP did not increase ischemic cholangiopathy. Thus, BDIS may overestimate this risk after liver NMP. Frontiers Media S.A. 2023-09-04 /pmc/articles/PMC10505658/ /pubmed/37727383 http://dx.doi.org/10.3389/ti.2023.11645 Text en Copyright © 2023 Gilbo, Neil, Brais, Fieuws, Lo Faro, Friend, Ploeg and Monbaliu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Archive
Gilbo, Nicholas
Neil, Desley
Brais, Rebecca
Fieuws, Steffen
Lo Faro, Letizia
Friend, Peter
Ploeg, Rutger
Monbaliu, Diethard
The Effect of Continuous Liver Normothermic Machine Perfusion on the Severity of Histological Bile Duct Injury
title The Effect of Continuous Liver Normothermic Machine Perfusion on the Severity of Histological Bile Duct Injury
title_full The Effect of Continuous Liver Normothermic Machine Perfusion on the Severity of Histological Bile Duct Injury
title_fullStr The Effect of Continuous Liver Normothermic Machine Perfusion on the Severity of Histological Bile Duct Injury
title_full_unstemmed The Effect of Continuous Liver Normothermic Machine Perfusion on the Severity of Histological Bile Duct Injury
title_short The Effect of Continuous Liver Normothermic Machine Perfusion on the Severity of Histological Bile Duct Injury
title_sort effect of continuous liver normothermic machine perfusion on the severity of histological bile duct injury
topic Health Archive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505658/
https://www.ncbi.nlm.nih.gov/pubmed/37727383
http://dx.doi.org/10.3389/ti.2023.11645
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