title: Hypothermic machine preservation in human liver transplantation: the first clinical series.
abstract: Hypothermic machine perfusion (HMP) is widely used to preserve kidneys for transplantation with improved results over cold storage (CS). To date, successful transplantation of livers preserved with HMP has been reported only in animal models. In this, the first prospective liver HMP study, 20 adults received HMP-preserved livers and were compared to a matched group transplanted with CS livers. HMP was performed for 3-7 h using centrifugal perfusion with Vasosol solution at 4-6 degrees C. There were no cases of primary nonfunction in either group. Early allograft dysfunction rates were 5% in the HMP group versus 25% in controls (p = 0.08). At 12 months, there were two deaths in each group, all unrelated to preservation or graft function. There were no vascular complications in HMP livers. Two biliary complications were observed in HMP livers compared with four in the CS group. Serum injury markers were significantly lower in the HMP group. Mean hospital stay was shorter in the HMP group (10.9 +/- 4.7 days vs. 15.3 +/- 4.9 days in the CS group, p = 0.006). HMP of donor livers provided safe and reliable preservation in this pilot case-controlled series. Further multicenter HMP trials are now warranted.
authors: Center for Liver Disease and Transplantation, Department of Surgery, Columbia University Medical Center, New York, NY, USA. jjg46@columbia.edu
authors: J V
authors: JV
authors: Guarrera
authors: S D
authors: SD
authors: Henry
authors: B
authors: B
authors: Samstein
authors: R
authors: R
authors: Odeh-Ramadan
authors: M
authors: M
authors: Kinkhabwala
authors: M J
authors: MJ
authors: Goldstein
authors: L E
authors: LE
authors: Ratner
authors: J F
authors: JF
authors: Renz
authors: H T
authors: HT
authors: Lee
authors: R S
authors: RS
authors: Brown
authors: J C
authors: JC
authors: Emond
mesh_terms: D000328:Adult; D015925:Cryopreservation; D006801:Humans; D007035:Hypothermia / Q000503:physiopathology; D008099:Liver / Q000503:physiopathology; D008111:Liver Function Tests; D016031:Liver Transplantation; D010477:Perfusion / Q000379:methods