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Prolonged Preservation by Hypothermic Machine Perfusion Facilitates Logistics in Liver Transplantation: A European Observational Cohort Study

I. M. Brüggenwirth1, M. Mueller2, V. A. Lantinga1, S. Camagni3, R. De Carlis4, L. De Carlis5, M. Colledan6, D. Dondossola7, M. Drefs8, J. Eden2, D. Ghinolfi9, D. Koliogiannis10, G. Lurje11, T. Manzia12, D. Monbaliu13, P. Muisean14, D. Patrono15, J. Pratschke16, R. Romagnoli17, M. Rayar18, F. Roma14, A. Schlegel2, P. Dutkowski2, R. J. Porte1, V. E. de Meijer1

1University Medical Center Groningen, Groningen, Netherlands, 2University Hospital Zurich, Zurich, Switzerland, 3ASST Papa Giovanni XXIII, Bergamo, Italy, 4ASST Grande Ospedale Metropolitano Niguarda, Niguarda, Italy, 5Niguarda Ca’ Granda Hospital, Niguarda, Italy, 6Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy, 7Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy, 8University of Munich, Munich, Germany, 9Azienda Ospedaliero Universitaria Pisana, Pisa, Italy, 10Hospital of the University of Munich, Munich, Germany, 11Charité Universitätsmedizin Berlin, Berlin, Germany, 12Tor Vergata University, Rome, Italy, 13KU Leuven University Hospitals Leuven, Leuven, Belgium, 14Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy, 15A. O. U. Città della Salute e della Scienza di Torino, Turin, Italy, 16Charite Universitatsmedizin Berlin, Berlin, Germany, 17AOU Città della Salute e della Scienza di Torino, Turin, Italy, 18CHU Pontchaillou, Rennes, France

Meeting: 2022 American Transplant Congress

Abstract number: 443

Keywords: Liver preservation, Liver transplantation, Machine preservation, Outcome

Topic: Clinical Science » Organ Inclusive » 69 - Non-Organ Specific:Organ Preservation/Ischemia Reperfusion Injury

Session Information

Session Name: Surgical Issues: Donor and Recipient

Session Type: Rapid Fire Oral Abstract

Date: Tuesday, June 7, 2022

Session Time: 3:30pm-5:00pm

 Presentation Time: 4:40pm-4:50pm

Location: Hynes Room 310

*Purpose: A short period (1-2 hours) of hypothermic oxygenated machine perfusion (HOPE) after static cold storage is safe and reduces ischemia-reperfusion injury-related complications after liver transplantation. Machine perfusion time is occasionally prolonged for logistical reasons, but outcomes after prolonged HOPE are currently unknown. The purpose of this study was to investigate if prolonged HOPE is safe and does notcompromise postoperative outcomes.

*Methods: We conducted a multicenter, observational cohort study of patients transplanted with a donor liver preserved by prolonged (≥4 hours) HOPE. Postoperative biochemistry, outcomes, complications, and survival were evaluated.

*Results: The total cohort included 93 recipients of 12 European transplant centers between 2014-2021. The most common reason to extend HOPE was the lack of an available operating room to start the transplant procedure. Grafts underwent HOPE for a median (range) of 4:37h (4:00- 8:15h) with a total preservation time of 10:45h (5:50-20:50h). Postoperative peak ALT was 595 IU/L (interquartile range 372-1214 IU/L). The incidence of postoperative complications was low, and 1-year graft and patient survival were 93%, and 92%, respectively.

*Conclusions: Good outcomes are achieved after transplantation of donor livers preserved with prolonged (≥4 hours) HOPE. These results suggest that simple, end-ischemic HOPE may be utilized for safe extension of the preservation time to ease transplantation logistics.

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To cite this abstract in AMA style:

Brüggenwirth IM, Mueller M, Lantinga VA, Camagni S, Carlis RDe, Carlis LDe, Colledan M, Dondossola D, Drefs M, Eden J, Ghinolfi D, Koliogiannis D, Lurje G, Manzia T, Monbaliu D, Muisean P, Patrono D, Pratschke J, Romagnoli R, Rayar M, Roma F, Schlegel A, Dutkowski P, Porte RJ, Meijer VEde. Prolonged Preservation by Hypothermic Machine Perfusion Facilitates Logistics in Liver Transplantation: A European Observational Cohort Study [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/prolonged-preservation-by-hypothermic-machine-perfusion-facilitates-logistics-in-liver-transplantation-a-european-observational-cohort-study/. Accessed May 30, 2025.

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