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 Detalle_Publicacion

Abdominal normothermic regional perfusion in controlled donation after circulatory determination of death liver transplantation: Outcomes and risk factors for graft loss

Abstract: Postmortem normothermic regional perfusion (NRP) is a rising preservation strategy in controlled donation after circulatory determination of death (cDCD). Herein, we present results for cDCD liver transplants performed in Spain 2012-2019, with outcomes evaluated through December 31, 2020. Results were analyzed retrospectively and according to recovery technique (abdominal NRP [A-NRP] or standard rapid recovery [SRR]). During the study period, 545 cDCD liver transplants were performed with A-NRP and 258 with SRR. Median donor age was 59 years (interquartile range 49-67 years). Adjusted risk estimates were improved with A-NRP for overall biliary complications (OR 0.300, 95% CI 0.197-0.459, p < .001), ischemic type biliary lesions (OR 0.112, 95% CI 0.042-0.299, p < .001), graft loss (HR 0.371, 95% CI 0.267-0.516, p < .001), and patient death (HR 0.540, 95% CI 0.373-0.781, p = .001). Cold ischemia time (HR 1.004, 95% CI 1.001-1.007, p = .021) and re-transplantation indication (HR 9.552, 95% CI 3.519-25.930, p < .001) were significant independent predictors for graft loss among cDCD livers with A-NRP. While use of A-NRP helps overcome traditional limitations in cDCD liver transplantation, opportunity for improvement remains for cases with prolonged cold ischemia and/or technically complex recipients, indicating a potential role for complimentary ex situ perfusion preservation techniques.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: American Journal of Transplantation, 2022, 22(4),1169-1181

Editorial: Wiley Periodicals Inc.

 Año de publicación: 2022

Nº de páginas: 13

Tipo de publicación: Artículo de Revista

 DOI: 10.1111/ajt.16899

ISSN: 1600-6135,1600-6143

Url de la publicación: https://www.doi.org/10.1111/ajt.16899

Autoría

HESSHEIMER, AMELIA J

DE LA ROSA, GLORIA

GASTACA, MIKEL

RUÍZ, PATRICIA

OTERO, ALEJANDRA

GÓMEZ, MANUEL

ALCONCHEL, FELIPE

RAMÍREZ, PABLO

BOSCA, ANDREA

LÓPEZ-ANDÚJAR, RAFAEL

ATUTXA, LÁNDER

ROYO-VILLANOVA, MARIO

SÁNCHEZ, BELINDA

SANTOYO, JULIO

MARÍN, LUÍS M

GÓMEZ-BRAVO, MIGUEL Á

MOSTEIRO, FERNANDO

VILLEGAS HERRERA, MARÍA T

VILLAR DEL MORAL, JESÚS