Normothermic Machine Perfusion Reduces Transfusion Requirements Even After Static Cold Storage: A 1 y Retrospective...

Area of Science:

• Transplantation immunology
• Organ preservation techniques
• Surgical outcomes research

Background:

• Normothermic machine perfusion (NMP) is known to improve liver graft outcomes.
• Static cold storage (SCS) is the traditional method for liver graft preservation.
• The benefit of adding NMP after SCS (NMP after SCS) remains less understood.

Purpose of the Study:

• To evaluate the impact of NMP after SCS on postreperfusion hemodynamics and transfusion requirements.
• To compare outcomes between liver grafts preserved with NMP after SCS and those preserved with SCS alone.

Main Methods:

• A retrospective analysis of 18 recipients of NMP after SCS liver grafts.
• Matching recipients with SCS grafts in a 1:2 ratio based on recipient and donor age, and MELD score.
• Comparison of postreperfusion hemodynamics, catecholamine use, and transfusion of blood products and clotting factors.

Main Results:

• The NMP after SCS group showed significantly reduced requirements for packed red blood cells (P < 0.001) and platelet concentrates (P = 0.018).
• Less fibrinogen concentrate was administered to the NMP after SCS group (P = 0.0163).
• No significant differences in postreperfusion hemodynamics were observed between the groups.

Conclusions:

• NMP following SCS reduces the need for red blood cells, platelets, and fibrinogen concentrate post-reperfusion.
• This strategy is feasible in centers with NMP availability, potentially improving graft utilization.
• NMP after SCS offers a viable option to mitigate transfusion needs in liver transplantation.