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Updated: Jan 25, 2026
Ex Situ Normothermic Machine Perfusion of Donor Livers
Published on: May 26, 2015
Propofol intravenous anaesthesia with desflurane compared with desflurane alone on postoperative liver function after
Seokyung Shin1, Dong J Joo, Myoung S Kim
1From the Department of Anesthesiology and Pain Medicine, Severance Hospital (SS, MIB, EH, YCY), Anesthesia and Pain Research Institute, Yonsei University College of Medicine (SS, MIB, EH, J-SL, YCY), Department of Surgery, Yonsei University College of Medicine (DJJ, MSK), Department of Anesthesiology and Pain Medicine, Gangnam Severance Hospital, Seoul (J-SL) and Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang-si, Gyeonggi-do, South Korea (DWK).
Background:
Propofol is an anaesthetic that resembles α-tocopherol and it has been suggested that it protects against ischaemia-reperfusion injury in liver transplantation. Living-donor liver transplantation (LDLT) presents an opportunity to test this hypothesis in both donors and recipients.
Objectives:
We compared clinical outcomes after LDLT following anaesthesia with propofol and desflurane against desflurane alone.
Design:
A randomised, parallel study.
Setting:
Single-centre trial, study period June 2014 and May 2017.
Patients:
Sixty-two pairs of adult donors and recipients who underwent LDLT.
Intervention:
Patients were randomised to receive either desflurane balanced anaesthesia or propofol total intravenous anaesthesia combined with desflurane anaesthesia.
Main Outcome Measures:
The primary outcome was peak liver transaminase levels during the first 7 days after surgery. Liver function was assessed at 10 different time-points (before surgery, 1 h after reperfusion, upon arrival in the ICU, and daily until postoperative day 7). Creatinine was measured to evaluate the incidence of acute kidney injury. TNF-α, IL-1β, IL-6 and TGF-β1 were assessed in 31 donors after induction, at hepatectomy and at the end of surgery and in 52 recipients after induction, and 1, 3 and 24 h after reperfusion.
Results:
Peak liver transaminase levels were not significantly different between the two groups. Liver function tests and creatinine were also similar between groups at all time-points. There was no difference in the incidence of postoperative complications, including acute kidney injury. With the exception of higher TNF-α in donors of the Propofol group at hepatectomy (0.60 ± 0.29 vs. 1.03 ± 0.53, P = 0.01) cytokine results were comparable between the two groups.
Conclusion:
Despite the simultaneous administration of propofol infusion in both donors and recipients, no improvement in laboratory or surgical outcome was observed after LDLT compared with patients who received desflurane anaesthesia alone.
Trial Registration:
NCT02504138 at clinicaltrials.gov.
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