Improved outcomes after hypothermic oxygenated machine perfusion in liver transplantation-long-term follow-up of a multicenter randomized controlled trial

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F24%3A00084565" target="_blank" >RIV/00023001:_____/24:00084565 - isvavai.cz</a>

Result on the web

<a href="https://journals.lww.com/hepcomm/fulltext/2024/02010/improved_outcomes_after_hypothermic_oxygenated.16.aspx" target="_blank" >https://journals.lww.com/hepcomm/fulltext/2024/02010/improved_outcomes_after_hypothermic_oxygenated.16.aspx</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1097/HC9.0000000000000376" target="_blank" >10.1097/HC9.0000000000000376</a>

Result language

angličtina

Original language name

Improved outcomes after hypothermic oxygenated machine perfusion in liver transplantation-long-term follow-up of a multicenter randomized controlled trial

Original language description

Background: While 4 randomized controlled clinical trials confirmed the early benefits of hypothermic oxygenated machine perfusion (HOPE), high-level evidence regarding long-term clinical outcomes is lacking. The aim of this follow-up study from the HOPE-ECD-DBD trial was to compare long-term outcomes in patients who underwent liver transplantation using extended criteria donor allografts from donation after brain death (ECD-DBD), randomized to either HOPE or static cold storage (SCS). Methods: Between September 2017 and September 2020, recipients of liver transplantation from 4 European centers receiving extended criteria donor-donation after brain death allografts were randomly assigned to HOPE or SCS (1:1). Follow-up data were available for all patients. Analyzed endpoints included the incidence of late-onset complications (occurring later than 6 months and graded according to the Clavien-Dindo Classification and the Comprehensive Complication Index) and long-term graft survival and patient survival. Results: A total of 46 patients were randomized, 23 in both arms. The median follow-up was 48 months (95% CI: 41-55). After excluding early perioperative morbidity, a significant reduction in late-onset morbidity was observed in the HOPE group (median reduction of 23 Comprehensive Complication Index-points [p=0.003] and lower incidence of major complications [Clavien-Dindo &gt;= 3, 43% vs. 85%, p=0.009]). Primary graft loss occurred in 13 patients (HOPE n=3 vs. SCS n=10), resulting in a significantly lower overall graft survival (p=0.029) and adverse 1-, 3-, and 5-year survival probabilities in the SCS group, which did not reach the level of significance (HOPE 0.913, 0.869, 0.869 vs. SCS 0.783, 0.606, 0.519, respectively). Conclusions:Our exploratory findings indicate that HOPE reduces late-onset morbidity and improves long-term graft survival providing clinical evidence to further support the broad implementation of HOPE in human liver transplantation.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30219 - Gastroenterology and hepatology

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2024

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Hepatology communications

ISSN

2471-254X

e-ISSN

2471-254X

Volume of the periodical

8

Issue of the periodical within the volume

2

Country of publishing house

GB - UNITED KINGDOM

Number of pages

11

Pages from-to

"art. no. e0376"

UT code for WoS article

001156613700001

EID of the result in the Scopus database

2-s2.0-85189326254