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Updated: Feb 7, 2026

Ex Situ Normothermic Machine Perfusion of Donor Livers
Published on: May 26, 2015
Systematic review on the treatment of deceased organ donors
Anne C van Erp1, Leon F A van Dullemen1, Rutger J Ploeg2
1Department of Surgery, University Medical Centre Groningen, the Netherlands.
Background:
Currently, there is no consensus on which treatments should be a part of standard deceased-donor management to improve graft quality and transplantation outcomes. The objective of this systematic review was to evaluate the effects of treatments of the deceased, solid-organ donor on graft function and survival after transplantation.
Methods:
Pubmed, Embase, Cochrane, and Clinicaltrials.gov were systematically searched for randomized controlled trials that compared deceased-donor treatment versus placebo or no treatment.
Results:
A total of 33 studies were selected for this systematic review. Eleven studies were included for meta-analyses on three different treatment strategies. The meta-analysis on methylprednisolone treatment in liver donors (two studies, 183 participants) showed no effect of the treatment on rates of acute rejection. The meta-analysis on antidiuretic hormone treatment in kidney donors (two studies, 222 participants) indicates no benefit in the prevention of delayed graft function. The remaining meta-analyses (seven studies, 334 participants) compared the effects of 10 min of ischaemic preconditioning on outcomes after liver transplantation and showed that ischaemic preconditioning improved short-term liver function, but not long-term transplant outcomes.
Conclusions:
There is currently insufficient evidence to conclude that any particular drug treatment or any intervention in the deceased donor improves long-term graft or patient survival after transplantation.
Insights
This systematic review found no evidence that deceased donor treatments improve long-term transplant outcomes. Further research is needed to optimize graft quality and patient survival after organ transplantation.
Area of Science:
- Transplantation immunology
- Organ preservation
- Graft survival optimization
Background:
- Lack of consensus on standard deceased-donor management protocols.
- Need to improve graft quality and transplantation outcomes.
- Importance of evaluating interventions in deceased donors.
Purpose of the Study:
- Systematically review the effects of deceased-donor treatments on graft function.
- Evaluate the impact of these treatments on post-transplantation survival.
Main Methods:
- Systematic search of PubMed, Embase, Cochrane, and Clinicaltrials.gov.
- Inclusion of randomized controlled trials comparing donor treatments to placebo or no treatment.
- Meta-analyses conducted on specific treatment strategies.
Main Results:
- Methylprednisolone in liver donors showed no effect on acute rejection rates.
- Antidiuretic hormone in kidney donors did not prevent delayed graft function.
- Ischaemic preconditioning improved short-term liver function but not long-term outcomes.
Conclusions:
- Insufficient evidence to support any specific deceased-donor treatment for improving long-term graft or patient survival.
- Further research is required to establish effective donor management strategies.
- Current interventions lack proven efficacy in enhancing transplant success.
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