Normothermic Machine Perfusion and Liver Transplant Waitlist Times: A Single-Center Matched Cohort Study

IF 1.7 3区医学 Q2 SURGERY

Journal of Surgical Research Pub Date : 2025-10-01 DOI:10.1016/j.jss.2025.03.064

Belen Rivera MD , Gabriel Cojuc-Konigsberg MD , Stalin Canizares MD , Ritah R. Chumdermpadetsuk MD , Martin Dib MD , David Lee MD , Devin E. Eckhoff MD

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引用次数: 0

Abstract

Introduction

Normothermic machine perfusion (NMP) is a promising technology for expanding the donor liver pool. This study aims to evaluate the association between the implementation of NMP on liver transplant waitlist times at a single center.

Methods

We conducted a retrospective cohort study of patients who underwent liver transplant at Beth Israel Deaconess Medical Center from 2014 to 2024. Waitlist times were compared between pre-NMP and post-NMP implementation periods. Matched cohorts based on sex, age, and the model for end-stage liver disease score were used to compare patients who received machine-perfused livers (NMP group) and those who did not (non-NMP group). Waitlist duration, donor type, hospital stay, overall survival, and graft failure were measured. A subgroup of patients diagnosed with hepatocellular carcinoma (HCC) was analyzed.

Results

Of 429 patients, median waitlist times were significantly reduced from 309 d pre-NMP to 48 d post-NMP (P < 0.001). In the matched analysis, the NMP group had a median waitlist time of 71 d, compared to 345 d for non-NMP group (P < 0.001). The NMP group had a 2-d shorter hospital stay than the non-NMP group (P < 0.001). For HCC patients, waitlist times decreased from 472 d pre-NMP to 83 d post-NMP (P < 0.001), and in the matched HCC cohorts, waitlist times decreased from 492 d to 121 d in the non-NMP and NMP groups, respectively (P < 0.001).

Conclusions

NMP implementation was associated with significantly shorter liver transplant waitlist times and reduced hospital stays, without compromising short-term survival outcomes. NMP may address the liver transplant shortage and improve access for patients, particularly those with HCC.

查看原文本刊更多论文

常温机器灌注与肝移植等待时间：一项单中心匹配队列研究。

常温机器灌注（NMP）是一种很有前途的扩大供肝池的技术。本研究旨在评估单个中心实施NMP与肝移植等待时间之间的关系。方法：对2014年至2024年在贝斯以色列女执事医疗中心接受肝移植的患者进行回顾性队列研究。比较nmp实施前和nmp实施后的等待名单时间。基于性别、年龄和终末期肝病评分模型的匹配队列用于比较接受机器灌注肝脏的患者（NMP组）和未接受机器灌注肝脏的患者（非NMP组）。等待名单持续时间、供体类型、住院时间、总生存期和移植物失败被测量。我们分析了一组诊断为肝细胞癌（HCC）的患者。结果：在429例患者中，中位等待时间从nmp前的309天显著减少到nmp后的48天（P < 0.001）。在匹配分析中，NMP组的中位等待时间为71天，而非NMP组的中位等待时间为345天（P < 0.001）。NMP组比非NMP组住院时间短2 d （P < 0.001）。对于HCC患者，等待时间从NMP前的472天减少到NMP后的83天（P < 0.001），而在匹配的HCC队列中，非NMP组和NMP组的等待时间分别从492天减少到121天（P < 0.001）。结论：NMP的实施与肝移植等待时间的缩短和住院时间的缩短显著相关，且不影响短期生存结果。NMP可以解决肝移植短缺问题，并改善患者，特别是HCC患者的可及性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Research 医学-外科

CiteScore

3.90

自引率

4.50%

发文量

627

审稿时长

138 days

期刊介绍： The Journal of Surgical Research: Clinical and Laboratory Investigation publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. The journal emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers. The articles presented need not have been the products of surgeons or of surgical laboratories. The Journal of Surgical Research also features review articles and special articles relating to educational, research, or social issues of interest to the academic surgical community.