Hypothermic Oxygenated New Machine Perfusion System in Liver and Kidney Transplantation of Extended Criteria Donors:First Italian Clinical Trial

• Published in: Scientific reports 2020-04, Vol.10 (1), p.6063-6063, Article 6063
• Main Authors: Ravaioli, Matteo, De Pace, Vanessa, Angeletti, Andrea, Comai, Giorgia, Vasuri, Francesco, Baldassarre, Maurizio, Maroni, Lorenzo, Odaldi, Federica, Fallani, Guido, Caraceni, Paolo, Germinario, Giuliana, Donadei, Chiara, Malvi, Deborah, Del Gaudio, Massimo, Bertuzzo, Valentina Rosa, Siniscalchi, Antonio, Ranieri, Vito Marco, D’Errico, Antonietta, Pasquinelli, Gianandrea, Morelli, Maria Cristina, Pinna, Antonio Daniele, Cescon, Matteo, La Manna, Gaetano
• Format: Article
• Language: English
• Subjects: 13; 14; 692/308/2779; 692/4022/272; 692/699/1585; Aged; Aspartate aminotransferase; Aspartate Aminotransferases - metabolism; Brain injury; Clinical trials; Cold Temperature; Cryopreservation; Donors; Female; Graft Survival; Humanities and Social Sciences; Humans; Infusion Pumps - adverse effects; Infusion Pumps - standards; Ischemia; Kidney - metabolism; Kidney transplantation; Kidney Transplantation - instrumentation; Kidney Transplantation - methods; Kidney transplants; Kidneys; Liver - metabolism; Liver diseases; Liver transplantation; Liver Transplantation - instrumentation; Liver Transplantation - methods; Male; Middle Aged; multidisciplinary; Organ Preservation - instrumentation; Organ Preservation - methods; Oxygenators, Membrane - adverse effects; Oxygenators, Membrane - standards; Perfusion; Perfusion - instrumentation; Perfusion - methods; Preservation; Science; Science (multidisciplinary); Tissue Donors; Transplants & implants
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-020-62979-9

With the aim to explore innovative tools for organ preservation, especially in marginal organs, we hereby describe a clinical trial of ex-vivo hypothermic oxygenated perfusion (HOPE) in the field of liver (LT) and kidney transplantation (KT) from Extended Criteria Donors (ECD) after brain death. A matched-case analysis of donor and recipient variables was developed: 10 HOPE-ECD livers and kidneys (HOPE-L and HOPE-K) were matched 1:3 with livers and kidneys preserved with static cold storage (SCS-L and SCS-K). HOPE and SCS groups resulted with similar basal characteristics, both for recipients and donors. Cumulative liver and kidney graft dysfunction were 10% (HOPE L-K) vs . 31.7%, in SCS group ( p  =  0.05 ). Primary non-function was 3.3% for SCS-L vs . 0% for HOPE-L. No primary non-function was reported in HOPE-K and SCS-K. Median peak aspartate aminotransferase within 7-days post-LT was significantly higher in SCS-L when compared to HOPE-L (637 vs .344 U/L, p  =  0.007 ). Graft survival at 1-year post-transplant was 93.3% for SCS-L vs. 100% of HOPE-L and 90% for SCS-K vs. 100% of HOPE-K. Clinical outcomes support our hypothesis of machine perfusion being a safe and effective system to reduce ischemic preservation injuries in KT and in LT.