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Hypothermic Oxygenated Machine Perfusion (HOPE) Prior to Liver Transplantation Mitigates Post-Reperfusion Syndrome and Perioperative Electrolyte Shifts

(1) Background: Post-reperfusion syndrome (PRS) and electrolyte shifts (ES) represent considerable challenges during liver transplantation (LT) being associated with significant morbidity. We aimed to investigate the impact of hypothermic oxygenated machine perfusion (HOPE) on PRS and ES in LT. (2)...

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Autores principales: Horné, Fabian, Drefs, Moritz, Schirren, Malte Joachim, Koch, Dominik Thomas, Cepele, Ganildo, Jacobi, Severin Johannes, Payani, Elnaz, Börner, Nikolaus, Werner, Jens, Guba, Markus Otto, Koliogiannis, Dionysios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9786550/
https://www.ncbi.nlm.nih.gov/pubmed/36555997
http://dx.doi.org/10.3390/jcm11247381
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author Horné, Fabian
Drefs, Moritz
Schirren, Malte Joachim
Koch, Dominik Thomas
Cepele, Ganildo
Jacobi, Severin Johannes
Payani, Elnaz
Börner, Nikolaus
Werner, Jens
Guba, Markus Otto
Koliogiannis, Dionysios
author_facet Horné, Fabian
Drefs, Moritz
Schirren, Malte Joachim
Koch, Dominik Thomas
Cepele, Ganildo
Jacobi, Severin Johannes
Payani, Elnaz
Börner, Nikolaus
Werner, Jens
Guba, Markus Otto
Koliogiannis, Dionysios
author_sort Horné, Fabian
collection PubMed
description (1) Background: Post-reperfusion syndrome (PRS) and electrolyte shifts (ES) represent considerable challenges during liver transplantation (LT) being associated with significant morbidity. We aimed to investigate the impact of hypothermic oxygenated machine perfusion (HOPE) on PRS and ES in LT. (2) Methods: In this retrospective study, we compared intraoperative parameters of 100 LTs, with 50 HOPE preconditioned liver grafts and 50 grafts stored in static cold storage (SCS). During reperfusion phase, prospectively registered serum parameters and vasopressor administration were analyzed. (3) Results: Twelve percent of patients developed PRS in the HOPE cohort vs. 42% in the SCS group (p = 0.0013). Total vasopressor demand in the first hour after reperfusion was lower after HOPE pretreatment, with reduced usage of norepinephrine (−26%; p = 0.122) and significant reduction of epinephrine consumption (−52%; p = 0.018). Serum potassium concentration dropped by a mean of 14.1% in transplantations after HOPE, compared to a slight decrease of 1% (p < 0.001) after SCS. The overall incidence of early allograft dysfunction (EAD) was reduced by 44% in the HOPE group (p = 0.04). (4) Conclusions: Pre-transplant graft preconditioning with HOPE results in higher hemodynamic stability during reperfusion and lower incidence of PRS and EAD. HOPE has the potential to mitigate ES by preventing hyperpotassemic complications that need to be addressed in LT with HOPE-pre-treated grafts.
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spelling pubmed-97865502022-12-24 Hypothermic Oxygenated Machine Perfusion (HOPE) Prior to Liver Transplantation Mitigates Post-Reperfusion Syndrome and Perioperative Electrolyte Shifts Horné, Fabian Drefs, Moritz Schirren, Malte Joachim Koch, Dominik Thomas Cepele, Ganildo Jacobi, Severin Johannes Payani, Elnaz Börner, Nikolaus Werner, Jens Guba, Markus Otto Koliogiannis, Dionysios J Clin Med Article (1) Background: Post-reperfusion syndrome (PRS) and electrolyte shifts (ES) represent considerable challenges during liver transplantation (LT) being associated with significant morbidity. We aimed to investigate the impact of hypothermic oxygenated machine perfusion (HOPE) on PRS and ES in LT. (2) Methods: In this retrospective study, we compared intraoperative parameters of 100 LTs, with 50 HOPE preconditioned liver grafts and 50 grafts stored in static cold storage (SCS). During reperfusion phase, prospectively registered serum parameters and vasopressor administration were analyzed. (3) Results: Twelve percent of patients developed PRS in the HOPE cohort vs. 42% in the SCS group (p = 0.0013). Total vasopressor demand in the first hour after reperfusion was lower after HOPE pretreatment, with reduced usage of norepinephrine (−26%; p = 0.122) and significant reduction of epinephrine consumption (−52%; p = 0.018). Serum potassium concentration dropped by a mean of 14.1% in transplantations after HOPE, compared to a slight decrease of 1% (p < 0.001) after SCS. The overall incidence of early allograft dysfunction (EAD) was reduced by 44% in the HOPE group (p = 0.04). (4) Conclusions: Pre-transplant graft preconditioning with HOPE results in higher hemodynamic stability during reperfusion and lower incidence of PRS and EAD. HOPE has the potential to mitigate ES by preventing hyperpotassemic complications that need to be addressed in LT with HOPE-pre-treated grafts. MDPI 2022-12-12 /pmc/articles/PMC9786550/ /pubmed/36555997 http://dx.doi.org/10.3390/jcm11247381 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Horné, Fabian
Drefs, Moritz
Schirren, Malte Joachim
Koch, Dominik Thomas
Cepele, Ganildo
Jacobi, Severin Johannes
Payani, Elnaz
Börner, Nikolaus
Werner, Jens
Guba, Markus Otto
Koliogiannis, Dionysios
Hypothermic Oxygenated Machine Perfusion (HOPE) Prior to Liver Transplantation Mitigates Post-Reperfusion Syndrome and Perioperative Electrolyte Shifts
title Hypothermic Oxygenated Machine Perfusion (HOPE) Prior to Liver Transplantation Mitigates Post-Reperfusion Syndrome and Perioperative Electrolyte Shifts
title_full Hypothermic Oxygenated Machine Perfusion (HOPE) Prior to Liver Transplantation Mitigates Post-Reperfusion Syndrome and Perioperative Electrolyte Shifts
title_fullStr Hypothermic Oxygenated Machine Perfusion (HOPE) Prior to Liver Transplantation Mitigates Post-Reperfusion Syndrome and Perioperative Electrolyte Shifts
title_full_unstemmed Hypothermic Oxygenated Machine Perfusion (HOPE) Prior to Liver Transplantation Mitigates Post-Reperfusion Syndrome and Perioperative Electrolyte Shifts
title_short Hypothermic Oxygenated Machine Perfusion (HOPE) Prior to Liver Transplantation Mitigates Post-Reperfusion Syndrome and Perioperative Electrolyte Shifts
title_sort hypothermic oxygenated machine perfusion (hope) prior to liver transplantation mitigates post-reperfusion syndrome and perioperative electrolyte shifts
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9786550/
https://www.ncbi.nlm.nih.gov/pubmed/36555997
http://dx.doi.org/10.3390/jcm11247381
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