Does Normothermic Regional Perfusion Improve the Results of Donation After Circulatory Death Liver Transplantation?

Transplant Proc. 2020 Jun;52(5):1477-1480. doi: 10.1016/j.transproceed.2020.01.088. Epub 2020 Apr 3.

Abstract

Background: The so-called grafts or donors with extended criteria are a risk factor for the development of liver transplant activity. One source comes from controlled donation after circulatory death (cDCD). The hypothesis was to verify the improvement in results by comparing DCD liver transplants performed with postmortem normothermic regional perfusion (NRP) vs super-rapid recovery (SRR), the current standard for cDCD. A prospective study comparing both techniques was carried out.

Methods: A total of 42 transplants were performed with cDCD, 22 of which were with SRR and 23 with NRP from April 2014 to September 2019.

Results: Differences were found in early allograft dysfunction (68.1% in the SRR group vs 25% in the NRP group; P < .01) and biliary complications (22.7% vs 5%, respectively; P = .04). Differences were also found, although not statistically significant, in ischemic cholangiopathy (13.6% in the SRR group vs 5% in the NRP group; P = .09), and retransplant rate (9.1% vs 0%, respectively; P = .3).

Conclusions: With the use of NRP machines, results are similar to the standard donation with donors in brain death in terms of rate of early allograft dysfunction and survival of the patient and graft attempted, reducing the rate of ischemic cholangiopathy compared with SRR.

Publication types

  • Observational Study

MeSH terms

  • Brain Death
  • Cold Ischemia
  • Female
  • Graft Survival
  • Humans
  • Liver Transplantation* / methods
  • Liver Transplantation* / mortality
  • Male
  • Middle Aged
  • Perfusion / methods*
  • Perfusion / mortality
  • Prospective Studies
  • Tissue Donors / supply & distribution*
  • Tissue and Organ Harvesting / methods*
  • Transplantation, Homologous
  • Warm Ischemia