Hypothermic Oxygenated Perfusion (HOPE) of the liver can reduce the incidence of early allograft dysfunction (EAD) and failure in extended criteria donors (ECD) grafts, although data from prospective studies are very limited. In this monocentric, open-label study, from December 2018 to January 2021, 110 patients undergoing transplantation of an ECD liver graft were randomized to receive a liver after HOPE or after static cold storage (SCS) alone. The primary endpoint was the incidence of EAD. The secondary endpoints included graft and patient survival, the EASE risk score, and the rate of graft or other graft-related complications. Patients in the HOPE group had a significantly lower rate of EAD (13% vs. 35%, p = .007) and were more frequently allocated to the intermediate or higher risk group according to the EASE score (2% vs. 11%, p = .05). The survival analysis confirmed that patients in the HOPE group were associated with higher graft survival one year after LT (p = .03, log-rank test). In addition, patients in the SCS group had a higher re-admission and overall complication rate at six months, in particular cardio-vascular adverse events (p = .04 and p = .03, respectively). HOPE of ECD grafts compared to the traditional SCS preservation method is associated with lower dysfunction rates and better graft survival.

Hypothermic oxygenated perfusion in extended criteria donor liver transplantation-A randomized clinical trial / Ravaioli, Matteo; Germinario, Giuliana; Dajti, Gerti; Sessa, Maurizio; Vasuri, Francesco; Siniscalchi, Antonio; Morelli, Maria Cristina; Serenari, Matteo; Del Gaudio, Massimo; Zanfi, Chiara; Odaldi, Federica; Bertuzzo, Valentina Rosa; Maroni, Lorenzo; Laurenzi, Andrea; Cescon, Matteo. - In: AMERICAN JOURNAL OF TRANSPLANTATION. - ISSN 1600-6135. - STAMPA. - 22:10(2022), pp. 2401-2408. [10.1111/ajt.17115]

Hypothermic oxygenated perfusion in extended criteria donor liver transplantation-A randomized clinical trial

Ravaioli, Matteo
Primo
;
Germinario, Giuliana
Secondo
;
Dajti, Gerti;Vasuri, Francesco;Serenari, Matteo;Del Gaudio, Massimo;Zanfi, Chiara;Odaldi, Federica;Bertuzzo, Valentina Rosa;Maroni, Lorenzo;Laurenzi, Andrea;Cescon, Matteo
2022

Abstract

Hypothermic Oxygenated Perfusion (HOPE) of the liver can reduce the incidence of early allograft dysfunction (EAD) and failure in extended criteria donors (ECD) grafts, although data from prospective studies are very limited. In this monocentric, open-label study, from December 2018 to January 2021, 110 patients undergoing transplantation of an ECD liver graft were randomized to receive a liver after HOPE or after static cold storage (SCS) alone. The primary endpoint was the incidence of EAD. The secondary endpoints included graft and patient survival, the EASE risk score, and the rate of graft or other graft-related complications. Patients in the HOPE group had a significantly lower rate of EAD (13% vs. 35%, p = .007) and were more frequently allocated to the intermediate or higher risk group according to the EASE score (2% vs. 11%, p = .05). The survival analysis confirmed that patients in the HOPE group were associated with higher graft survival one year after LT (p = .03, log-rank test). In addition, patients in the SCS group had a higher re-admission and overall complication rate at six months, in particular cardio-vascular adverse events (p = .04 and p = .03, respectively). HOPE of ECD grafts compared to the traditional SCS preservation method is associated with lower dysfunction rates and better graft survival.
2022
Hypothermic oxygenated perfusion in extended criteria donor liver transplantation-A randomized clinical trial / Ravaioli, Matteo; Germinario, Giuliana; Dajti, Gerti; Sessa, Maurizio; Vasuri, Francesco; Siniscalchi, Antonio; Morelli, Maria Cristina; Serenari, Matteo; Del Gaudio, Massimo; Zanfi, Chiara; Odaldi, Federica; Bertuzzo, Valentina Rosa; Maroni, Lorenzo; Laurenzi, Andrea; Cescon, Matteo. - In: AMERICAN JOURNAL OF TRANSPLANTATION. - ISSN 1600-6135. - STAMPA. - 22:10(2022), pp. 2401-2408. [10.1111/ajt.17115]
Ravaioli, Matteo; Germinario, Giuliana; Dajti, Gerti; Sessa, Maurizio; Vasuri, Francesco; Siniscalchi, Antonio; Morelli, Maria Cristina; Serenari, Matteo; Del Gaudio, Massimo; Zanfi, Chiara; Odaldi, Federica; Bertuzzo, Valentina Rosa; Maroni, Lorenzo; Laurenzi, Andrea; Cescon, Matteo
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/907365
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