Trends and Obstacles to Implement Dynamic Perfusion Concepts for Clinical Liver Transplantation: Results from a Global Web-Based Survey

Organ perfusion technology is increasingly used in many countries, with a focus, however, on the Western world. This study investigates the current international trends and obstacles to the broader routine implementation of dynamic perfusion concepts in liver transplantation. A web-based anonymous s...

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Bibliographic Details
Published in:Journal of clinical medicine 2023-05, Vol.12 (11), p.3765
Main Authors: Parente, Alessandro, Flores Carvalho, Mauricio, Panconesi, Rebecca, Boteon, Yuri L, De Carlis, Riccardo, Dutkowski, Philipp, Muiesan, Paolo, Dondossola, Daniele, Schlegel, Andrea
Format: Article
Language:English
Subjects:
Clinical medicine
Cold storage
Hospitals
International aspects
Isolation perfusion (Physiology)
Liver
Liver transplants
Medical equipment
Nurses
Questionnaires
Social networks
Surgeons
Surveys
Transplantation
Transplants & implants
Trends
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Summary:Organ perfusion technology is increasingly used in many countries, with a focus, however, on the Western world. This study investigates the current international trends and obstacles to the broader routine implementation of dynamic perfusion concepts in liver transplantation. A web-based anonymous survey was launched in 2021. Experts of all involved specializations from 70 centers in 34 countries were contacted, based on the published literature and experience in the field of abdominal organ perfusion. Overall, 143 participants from 23 countries completed the survey. Most respondents were male (67.8%) and transplant surgeons (64.3%) working at university hospitals (67.9%). The majority had experience with organ perfusion (82%), applying mainly hypothermic machine perfusion (HMP; 38%) and other concepts. While most (94.4%) expect a higher utilization of marginal organs with machine perfusion, the majority considers HMP the best technique to reduce liver discard-rates. While most respondents (90%) believed machine perfusion should be fully commissioned, the lack of funding (34%) and knowledge (16%) as well as limited staff (19%) were the three main obstacles to a routine clinical implementation. Although dynamic preservation concepts are increasingly used in clinical practice, significant challenges remain. Specific financial pathways, uniform regulations, and tight collaborations among involved experts are needed to achieve wider global clinical use.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm12113765