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A Meta-Analysis and Systematic Review of Normothermic and Hypothermic Machine Perfusion in Liver Transplantation

Background: The gap between the demand and supply of donor livers is still a considerable challenge. Since static cold storage is not sufficient in marginal livers, machine perfusion is being explored as an alternative. The objective of this study was to assess (dual) hypothermic oxygenated machine...

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Autores principales: Mugaanyi, Joseph, Dai, Lei, Lu, Changjiang, Mao, Shuqi, Huang, Jing, Lu, Caide
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9820958/
https://www.ncbi.nlm.nih.gov/pubmed/36615037
http://dx.doi.org/10.3390/jcm12010235
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author Mugaanyi, Joseph
Dai, Lei
Lu, Changjiang
Mao, Shuqi
Huang, Jing
Lu, Caide
author_facet Mugaanyi, Joseph
Dai, Lei
Lu, Changjiang
Mao, Shuqi
Huang, Jing
Lu, Caide
author_sort Mugaanyi, Joseph
collection PubMed
description Background: The gap between the demand and supply of donor livers is still a considerable challenge. Since static cold storage is not sufficient in marginal livers, machine perfusion is being explored as an alternative. The objective of this study was to assess (dual) hypothermic oxygenated machine perfusion (HOPE/D-HOPE) and normothermic machine perfusion (NMP) in contrast to static cold storage (SCS). Methods: Three databases were searched to identify studies about machine perfusion. Graft and patient survival and postoperative complications were evaluated using the random effects model. Results: the incidence of biliary complications was lower in HOPE vs. SCS (OR: 0.59, 95% CI: 0.36–0.98, p = 0.04, I(2): 0%). There was no significant difference in biliary complications between NMP and SCS (OR: 0.76, 95% CI: 0.41–1.40, p = 0.38, I(2): 55%). Graft and patient survival were significantly better in HOPE than in SCS (HR: 0.40, 95% CI: 0.23–0.71, p = 0.002, I(2): 0%) and (pooled HR: 0.43, 95% CI: 0.20–0.93, p = 0.03, I(2): 0%). Graft and patient survival were not significantly different between NMP and SCS. Conclusion: HOPE/D-HOPE and NMP are promising alternatives to SCS for donor liver preservation. They may help address the widening gap between the demand for and availability of donor livers by enabling the rescue and transplantation of marginal livers.
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spelling pubmed-98209582023-01-07 A Meta-Analysis and Systematic Review of Normothermic and Hypothermic Machine Perfusion in Liver Transplantation Mugaanyi, Joseph Dai, Lei Lu, Changjiang Mao, Shuqi Huang, Jing Lu, Caide J Clin Med Systematic Review Background: The gap between the demand and supply of donor livers is still a considerable challenge. Since static cold storage is not sufficient in marginal livers, machine perfusion is being explored as an alternative. The objective of this study was to assess (dual) hypothermic oxygenated machine perfusion (HOPE/D-HOPE) and normothermic machine perfusion (NMP) in contrast to static cold storage (SCS). Methods: Three databases were searched to identify studies about machine perfusion. Graft and patient survival and postoperative complications were evaluated using the random effects model. Results: the incidence of biliary complications was lower in HOPE vs. SCS (OR: 0.59, 95% CI: 0.36–0.98, p = 0.04, I(2): 0%). There was no significant difference in biliary complications between NMP and SCS (OR: 0.76, 95% CI: 0.41–1.40, p = 0.38, I(2): 55%). Graft and patient survival were significantly better in HOPE than in SCS (HR: 0.40, 95% CI: 0.23–0.71, p = 0.002, I(2): 0%) and (pooled HR: 0.43, 95% CI: 0.20–0.93, p = 0.03, I(2): 0%). Graft and patient survival were not significantly different between NMP and SCS. Conclusion: HOPE/D-HOPE and NMP are promising alternatives to SCS for donor liver preservation. They may help address the widening gap between the demand for and availability of donor livers by enabling the rescue and transplantation of marginal livers. MDPI 2022-12-28 /pmc/articles/PMC9820958/ /pubmed/36615037 http://dx.doi.org/10.3390/jcm12010235 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 Systematic Review
Mugaanyi, Joseph
Dai, Lei
Lu, Changjiang
Mao, Shuqi
Huang, Jing
Lu, Caide
A Meta-Analysis and Systematic Review of Normothermic and Hypothermic Machine Perfusion in Liver Transplantation
title A Meta-Analysis and Systematic Review of Normothermic and Hypothermic Machine Perfusion in Liver Transplantation
title_full A Meta-Analysis and Systematic Review of Normothermic and Hypothermic Machine Perfusion in Liver Transplantation
title_fullStr A Meta-Analysis and Systematic Review of Normothermic and Hypothermic Machine Perfusion in Liver Transplantation
title_full_unstemmed A Meta-Analysis and Systematic Review of Normothermic and Hypothermic Machine Perfusion in Liver Transplantation
title_short A Meta-Analysis and Systematic Review of Normothermic and Hypothermic Machine Perfusion in Liver Transplantation
title_sort meta-analysis and systematic review of normothermic and hypothermic machine perfusion in liver transplantation
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9820958/
https://www.ncbi.nlm.nih.gov/pubmed/36615037
http://dx.doi.org/10.3390/jcm12010235
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