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Technique of Subnormothermic Ex Vivo Liver Perfusion for the Storage, Assessment, and Repair of Marginal Liver Grafts
Published on: August 13, 2014
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Machine perfusion versus cold storage of livers: a meta-analysis
Sushun Liu1, Qing Pang1, Jingyao Zhang1
1Department of Hepatobiliary Surgery, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, 710061, China.
Frontiers of Medicine
|November 13, 2016
Summary
Machine perfusion (MP) is superior to static cold storage (CS) for preserving donation after cardiac death (DCD) livers in experimental models. MP reduces liver injury markers and improves function, offering better outcomes for liver transplantation.
Area of Science:
- Transplantation immunology
- Organ preservation techniques
- Surgical research
Background:
- Organ preservation is critical for successful liver transplantation outcomes.
- Donation after cardiac death (DCD) livers present unique preservation challenges.
- Comparing machine perfusion (MP) and static cold storage (CS) is essential for optimizing DCD liver viability.
Purpose of the Study:
- To compare the efficacy of machine perfusion (MP) versus static cold storage (CS) for preserving donation after cardiac death (DCD) livers.
- To evaluate key biochemical markers and physiological parameters in experimental models utilizing different preservation methods.
Main Methods:
- A meta-analysis was conducted on 24 experimental studies comparing MP and CS for DCD liver preservation.
- Data from two animal species were pooled to calculate standardized mean differences (SMD) and 95% confidence intervals (CI).
Main Results:
- Machine perfusion (MP) significantly reduced levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and hyaluronic acid (HA) compared to static cold storage (CS).
- MP also minimized changes in liver weight, enhanced bile production, and improved portal vein flow (PVF).
- Significant differences were observed in alkaline phosphatase (ALP) levels and histological outcomes between MP and CS.
Conclusions:
- Machine perfusion (MP) demonstrates superior outcomes compared to static cold storage (CS) for preserving DCD livers in experimental settings.
- MP offers significant benefits in reducing organ injury and improving functional parameters, potentially enhancing liver transplant success.
