Transplantation of discarded livers following viability testing with normothermic machine perfusion.

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ID: 253855
2020
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Abstract
There is a limited access to liver transplantation, however, many organs are discarded based on subjective assessment only. Here we report the VITTAL clinical trial (ClinicalTrials.gov number NCT02740608) outcomes, using normothermic machine perfusion (NMP) to objectively assess livers discarded by all UK centres meeting specific high-risk criteria. Thirty-one livers were enroled and assessed by viability criteria based on the lactate clearance to levels ≤2.5 mmol/L within 4 h. The viability was achieved by 22 (71%) organs, that were transplanted after a median preservation time of 18 h, with 100% 90-day survival. During the median follow up of 542 days, 4 (18%) patients developed biliary strictures requiring re-transplantation. This trial demonstrates that viability testing with NMP is feasible and in this study enabled successful transplantation of 71% of discarded livers, with 100% 90-day patient and graft survival; it does not seem to prevent non-anastomotic biliary strictures in livers donated after circulatory death with prolonged warm ischaemia.
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mergental2020transplantationnature Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Mergental, Hynek;Laing, Richard W;Kirkham, Amanda J;Perera, M Thamara P R;Boteon, Yuri L;Attard, Joseph;Barton, Darren;Curbishley, Stuart;Wilkhu, Manpreet;Neil, Desley A H;Hübscher, Stefan G;Muiesan, Paolo;Isaac, John R;Roberts, Keith J;Abradelo, Manuel;Schlegel, Andrea;Ferguson, James;Cilliers, Hentie;Bion, Julian;Adams, David H;Morris, Chris;Friend, Peter J;Yap, Christina;Afford, Simon C;Mirza, Darius F;
Journal Nature communications
Year 2020
DOI
10.1038/s41467-020-16251-3
URL
Keywords
refugees trauma violence bion fanon petrification unconscious

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