Liver transplantation after ex vivo normothermic machine preservation: a Phase 1 (first-in-man) clinical trial

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Authors

  • Reena Ravikumar
  • Wayel Jassem
  • Hynek Mergental
  • Nigel Heaton
  • Darius Mirza
  • And 6 others
  • M Thamara P R Perera
  • Alberto Quaglia
  • David Holroyd
  • Thomas Vogel
  • Constantin-C Coussios
  • Peter J Friend

Colleges, School and Institutes

Abstract

The number of donor organs suitable for liver transplantation is restricted by cold preservation and ischemia-reperfusion injury (IRI). We present the first patients transplanted using a normothermic machine perfusion (NMP) device that transports and stores an organ in a fully functioning state at 37°C. In this Phase 1 trial, organs were retrieved using standard techniques, attached to the perfusion device at the donor hospital and transported to the implanting centre in a functioning state. NMP livers were matched 1:2 to cold-stored livers. 20 patients underwent liver transplantation after NMP. Median NMP time was 9·3 (3·5 - 18·5) hours vs median CIT of 8·9 (4·2 - 11·4) hours. 30-day graft survival was similar (100% NMP vs. 97·5% Control, p=1·00). Median peak AST in the first 7 days was significantly lower in the NMP group (417 IU (84 - 4681)) vs (902 IU (218 - 8786), p=0·03). This first report of liver transplantation using NMP-preserved livers demonstrates the safety and feasibility of using this technology from retrieval to transplantation, including transportation. NMP may be valuable in increasing the number of donor livers improving the function of transplantable organs. This article is protected by copyright. All rights reserved.

Details

Original languageEnglish
JournalAmerican Journal of Transplantation
Publication statusPublished - 11 Jan 2016