Transplantation Reviews最新文献

{"title":"Exploring definitions of graft pancreatitis following pancreas transplantation: A scoping review","authors":"Stefano Partelli ,&nbsp;Valentina Andreasi ,&nbsp;Valentina Tomajer ,&nbsp;Domenico Tamburrino ,&nbsp;Rossana Caldara ,&nbsp;Paolo Rigotti ,&nbsp;Davide Catarinella ,&nbsp;Lorenzo Piemonti ,&nbsp;Massimo Falconi","doi":"10.1016/j.trre.2024.100861","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100861","url":null,"abstract":"<div><p>Despite the clinical relevance of graft pancreatitis (GP) after pancreas transplantation (PT), a universally accepted definition is lacking. Aim of this scoping review was to provide a systematic overview of GP definitions reported in the literature. MEDLINE, Web of Science and Embase were searched for relevant articles. Prospective/retrospective studies reporting a GP definition were included. The included series (<em>n</em> = 20) used four main criteria (clinical, biochemical, radiological and pathological) to define GP. Overall, 9 studies defined GP using a single criterion (<em>n</em> = 8 biochemical, <em>n</em> = 1 pathological), 7 series using two criteria (<em>n</em> = 3 clinical + biochemical, <em>n</em> = 3 biochemical + radiological, <em>n</em> = 1 clinical + radiological), 3 series using three criteria (<em>n</em> = 3 clinical + biochemical + radiological), and 1 series using four criteria. Overall, 20 definitions of GP were found. GP rate was reported by 19 series and ranged between 0% and 87%. This scoping review confirms that a universally accepted definition of GP is absent, and there is no consensus on the criteria on which it should be grounded. Future research should focus on developing a validated definition of GP.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100861"},"PeriodicalIF":4.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141308585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytomegalovirus infection and cardiovascular outcomes in abdominal organ transplant recipients: A systematic review and meta-analysis","authors":"Panos Arvanitis ,&nbsp;Michel R. Davis ,&nbsp;Dimitrios Farmakiotis","doi":"10.1016/j.trre.2024.100860","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100860","url":null,"abstract":"<div><h3>Introduction</h3><p>Despite advancements in Cytomegalovirus (CMV) management, its impact on graft function, mortality, and cardiovascular (CV) health of organ transplant recipients (OTR) remains a significant concern. We investigated the association between CMV infection and CV events (CVE) in organ (other than heart) transplant recipients.</p></div><div><h3>Methods</h3><p>We conducted a comprehensive literature search in PubMed and EMBASE, including studies that reported on CMV infection or disease and post-transplantation CVE. Studies of heart transplant recipients were excluded.</p></div><div><h3>Results</h3><p>We screened 3875 abstracts and 12 clinical studies were included in the final analysis, mainly in kidney and liver transplant recipients. A significant association was observed between CMV infection and an increased risk of CVE, with a pooled unadjusted hazard ratio (HR) of 1.99 (95% Confidence Intervals [CI] 1.45–2.73) for CMV infection and 1.59 (95% CI 1.21–2.10) for CMV disease. Pooled adjusted HR were 2.17 (95% CI 1.47–3.20) and 1.77 (95% CI 0.83–3.76), respectively. Heterogeneity was low (I² = 0%) for CMV infection, suggesting consistent association across studies, and moderate-to-high for CMVdisease (I² = 50% for unadjusted, 53% for adjusted HR).</p></div><div><h3>Discussion</h3><p>We found a significant association between CMV infection and CV risk in abdominal OTR, underscoring the importance of proactive CMV surveillance and early treatment. Future research should aim for more standardized methodologies to fully elucidate the relationship between CMV and CV outcomes, potentially informing novel preventive and therapeutic strategies that could benefit the CV health of OTR.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100860"},"PeriodicalIF":4.0,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141164530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A holistic review of sodium intake in kidney transplant patients: More questions than answers","authors":"Baris Afsar ,&nbsp;Rengin Elsurer Afsar ,&nbsp;Yasar Caliskan ,&nbsp;Krista L. Lentine","doi":"10.1016/j.trre.2024.100859","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100859","url":null,"abstract":"<div><p>Kidney transplantation (KT) is the best treatment option for end-stage kidney disease (ESKD). Acute rejection rates have decreased drastically in recent years but chronic kidney allograft disease (CKAD) is still an important cause of allograft failure and return to dialysis. Thus, there is unmet need to identify and reverse the cause of CKAD. Additionally, cardiovascular events after KT are still leading causes of morbidity and mortality. One overlooked potential contributor to CKAD and adverse cardiovascular events is increased sodium/salt intake in kidney transplant recipients (KTRs). In general population, the adverse effects of high sodium intake are well known but in KTRs, there is a paucity of evidence despite decades of experience with KT. Limited research showed that sodium intake is high in most KTRs. Moreover, excess sodium intake is associated with elevated blood pressure and albuminuria in some studies involving KTRs. There is also experimental evidence suggesting that increased sodium intake is associated with histologic graft damage.</p><p>Critical knowledge gaps still remain, including the exact amount of sodium restriction needed in KTRs to optimize outcomes and allograft survival. Additionally, best methods to measure sodium intake and practices to follow-up are not clarified in KTRs. To meet these deficits, prospective long term studies are warranted in KTRs. Moreover, preventive measures must be determined and implemented both at individual and societal levels to achieve sodium restriction in KTRs.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100859"},"PeriodicalIF":4.0,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140918105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of psychosocial and sex-based contributors to gender disparities in the United States across the steps towards kidney transplantation","authors":"Shelby A. Smout ,&nbsp;Emily M. Yang ,&nbsp;Dinushika Mohottige ,&nbsp;Camilla W. Nonterah","doi":"10.1016/j.trre.2024.100858","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100858","url":null,"abstract":"<div><h3>Introduction</h3><p>Persistent findings suggest women and patients identified as “female” are less likely to receive a kidney transplant. Furthermore, the limited research on transplantation among transgender and gender diverse people suggests this population is susceptible to many of the same psychosocial and systemic barriers.</p></div><div><h3>Objective</h3><p>This review sought to 1) highlight terminology used to elucidate gender disparities, 2) identify barriers present along the steps to transplantation, and 3) summarize contributors to gender disparities across the steps to transplantation.</p></div><div><h3>Methods</h3><p>A systematic review of gender and sex disparities in the steps towards kidney transplantation was conducted in accordance with PRISMA guidelines across four social science and public health databases from 2005 to 23.</p></div><div><h3>Results</h3><p>The search yielded 1696 initial results, 33 of which met inclusion criteria. A majority of studies followed a retrospective cohort design (<em>n</em> = 22, 66.7%), inconsistently used gender and sex related terminology (<em>n</em> = 21, 63.6%), and reported significant findings for gender and sex disparities within the steps towards transplantation (<em>n</em> = 28, 84.8%). Gender disparities among the earlier steps were characterized by patient-provider communication and perception of medical suitability whereas disparities in the later steps were characterized by differential outcomes based on older age, an above average BMI, and Black racial identity. Findings for transgender patients pointed to issues computing eGFR and the need for culturally tailored care.</p></div><div><h3>Discussion</h3><p>Providers should be encouraged to critically examine the diagnostic criteria used to determine transplant eligibility and adopt practices that can be culturally tailored to meet the needs of patients.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100858"},"PeriodicalIF":4.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140902404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunosuppressive drug combinations after kidney transplantation and post-transplant diabetes: A systematic review and meta-analysis","authors":"Laia Oliveras ,&nbsp;Ana Coloma ,&nbsp;Nuria Lloberas ,&nbsp;Luis Lino ,&nbsp;Alexandre Favà ,&nbsp;Anna Manonelles ,&nbsp;Sergi Codina ,&nbsp;Carlos Couceiro ,&nbsp;Edoardo Melilli ,&nbsp;Adnan Sharif ,&nbsp;Manfred Hecking ,&nbsp;Martina Guthoff ,&nbsp;Josep M. Cruzado ,&nbsp;Julio Pascual ,&nbsp;Nuria Montero","doi":"10.1016/j.trre.2024.100856","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100856","url":null,"abstract":"<div><p>Post-transplant diabetes mellitus (PTDM) is a frequent complication after kidney transplantation (KT). This systematic review investigated the effect of different immunosuppressive regimens on the risk of PTDM. We performed a systematic literature search in MEDLINE and CENTRAL for randomized controlled trials (RCTs) that included KT recipients with any immunosuppression and reported PTDM outcomes up to 1 October 2023. The analysis included 125 RCTs. We found no differences in PTDM risk within induction therapies. In de novo KT, there was an increased risk of developing PTDM with tacrolimus versus cyclosporin (RR 1.71, 95%CI [1.38-2.11]). No differences were observed between tacrolimus+mammalian target of rapamycin inhibitor (mTORi) and tacrolimus+MMF/MPA, but there was a tendency towards a higher risk of PTDM in the cyclosporin+mTORi group (RR 1.42, 95%CI [0.99-2.04]). Conversion from cyclosporin to an mTORi increased PTDM risk (RR 1.89, 95%CI [1.18-3.03]). De novo belatacept compared with a calcineurin inhibitor resulted in 50% lower risk of PTDM (RR 0.50, 95%CI [0.32-0.79]). Steroid avoidance resulted in 31% lower PTDM risk (RR 0.69, 95%CI [0.57-0.83]), whereas steroid withdrawal resulted in no differences. Immunosuppression should be decided on an individual basis, carefully weighing the risk of future PTDM and rejection.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100856"},"PeriodicalIF":4.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140880107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent complement-mediated Hemolytic uremic syndrome after kidney transplantation","authors":"Shota Obata ,&nbsp;Frank Hullekes ,&nbsp;Leonardo V. Riella ,&nbsp;Paolo Cravedi","doi":"10.1016/j.trre.2024.100857","DOIUrl":"10.1016/j.trre.2024.100857","url":null,"abstract":"<div><p>Hereditary forms of <em>hemolytic uremic syndrome</em> (HUS), formerly known as atypical HUS, typically involve mutations in genes encoding for components of the alternative pathway of complement, therefore they are often referred to as complement-mediated HUS (cHUS). This condition has a high risk of recurrence in the transplanted kidney, leading to accelerated graft loss. The availability of anti-complement component C5 antibody eculizumab has enabled successful transplantation with a notably reduced recurrence rate and improved prognosis. Open questions are related to the potential for complement inhibitor discontinuation, ideal timing of treatment withdrawal, and patient selection based on genetic abnormalities. Our review delves into the pathophysiology, classification, genetic predispositions, and management strategies for cHUS in the native and transplant kidneys.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100857"},"PeriodicalIF":4.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of living kidney donors: A synthesis of unsolicited patient narratives","authors":"Katya Loban ,&nbsp;Saly El Wazze ,&nbsp;Théa Milland ,&nbsp;Lindsay Hales ,&nbsp;Anita Slominska ,&nbsp;Shaifali Sandal","doi":"10.1016/j.trre.2024.100855","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100855","url":null,"abstract":"<div><h3>Introduction</h3><p>Despite the lauded benefits of living kidney donation, there is growing evidence of the challenges that living kidney donors (LKD) encounter in their donation trajectory and gaps in healthcare service provision. However, most of the evidence is derived from research conducted by clinicians or academic investigators. Significantly less attention has been devoted to analyzing unsolicited accounts of LKDs' experiences.</p></div><div><h3>Methods</h3><p>We conducted a review and synthesis of published unsolicited first-person narratives of LKDs and aimed to synthesize their experiences and identify care needs. Four electronic databases were searched and 27 LKD narratives were included in our final analysis. Thematic synthesis was used to generate themes inductively.</p></div><div><h3>Results</h3><p>Although the majority of LKDs reported the act of donation to be a fulfilling experience, almost 48% reported encountering challenges in the care that they received. Also, 29% of LKDs reported experiencing an adverse clinical event. Five distinct themes emerged surrounding the donation experience and healthcare needs: 1) Educational needs due to perceived lack of transparency and compensating for knowledge gaps; 2) Respect for donor autonomy due to coercive influences from family or healthcare providers, lack of respect for donor preferences and loopholes in the consent process; 3) Unmet care needs related to poor communication with healthcare providers, coordination issues and inconsistent and inadequate long-term care; 4) Unanticipated outcomes due to economic costs and the emotional burden of donation; and 5) Contributing beyond the donation event by advocating for a balanced view of donation and generating support mechanisms.</p></div><div><h3>Conclusion</h3><p>In this synthesis of LKDs narratives, important care gaps and the need to advocate for a balanced perspective on living kidney donation were highlighted. Our review underscores the value of patients' own stories as critical evidence that can inform improvement in healthcare service delivery.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100855"},"PeriodicalIF":4.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000387/pdfft?md5=355654ade176fce81810810b337fcaf3&pid=1-s2.0-S0955470X24000387-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140637857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diet and physical activity interventions to improve cardiovascular disease risk factors in liver transplant recipients: Systematic review and meta-analysis","authors":"Lynsey N. Spillman ,&nbsp;Emily Stowe ,&nbsp;Angela M. Madden ,&nbsp;Kirsten L. Rennie ,&nbsp;Linda M. Oude Griep ,&nbsp;Michael Allison ,&nbsp;Leia Kenney ,&nbsp;Ciara O'Connor ,&nbsp;Simon J. Griffin","doi":"10.1016/j.trre.2024.100852","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100852","url":null,"abstract":"<div><h3>Background and aims</h3><p>Cardiovascular disease, associated risk factors and obesity are prevalent after liver transplant and modifiable through lifestyle changes. Understanding what lifestyle interventions and their respective components are effective is essential for translation to clinical practice. We aimed to investigate the effects of diet and physical activity interventions on weight, body mass index and other cardiovascular disease risk factors in liver transplant recipients, and systematically describe the interventions.</p></div><div><h3>Methods</h3><p>We systematically searched Embase, MEDLINE, Psycho Info, CINAHL, Cochrane central register of controlled trials, PeDro, AMED, BNI, Web of Science, OpenGrey, <span>ClinicalTrials.gov</span><svg><path></path></svg> and the international clinical trials registry from inception to 31 May 2023. Search results were screened by two independent reviewers: randomised control trials with interventions that targeted diet and physical activity behaviours in liver transplant recipients were considered eligible. Two independent reviewers extracted and synthesised data for study, participant and intervention details and results. We used the Revised Cochrane Risk of Bias Tool for Randomised Trials to assess risk of bias for outcomes and the GRADE approach to rate the quality of the body of evidence. When two or more studies reported findings for an outcome, we pooled data using random-effects meta-analysis.</p></div><div><h3>Results</h3><p>Six studies were included, reporting three physical activity and three combined diet and physical activity interventions. Participants were 2 months-4 years post-transplant. Interventions lasted 12 weeks-10 months and were delivered remotely and/or in-person, most commonly delivered to individual participants by health care or sports professionals. Five studies described individual tailoring, e.g. exercise intensity. Adherence to interventions ranged from 51% to 94%. No studies reported fidelity. Intervention components were not consistently reported. In meta-analysis, diet and physical activity interventions did not significantly reduce weight or body mass index compared to control groups, however no studies targeted participants with obesity. Diet and physical activity interventions reduced percentage body fat and triglycerides compared to control groups but did not reduce total cholesterol or increase activity. The GRADE quality of evidence was low or very low.</p></div><div><h3>Conclusion</h3><p>Diet and physical activity interventions reduced percentage body fat and triglycerides in liver transplant recipients. Further good quality research is needed to evaluate their effect on other cardiovascular disease risk factors, including weight and BMI. Interventions need to be better described and evaluated to improve evidence base and inform patient care.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100852"},"PeriodicalIF":4.0,"publicationDate":"2024-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000351/pdfft?md5=84af9ad5e2279d500f4a54e0f7f8e0bc&pid=1-s2.0-S0955470X24000351-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140548534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of donor smoking history on kidney transplant recipient outcomes: A systematic review and meta-analysis","authors":"Christie Rampersad ,&nbsp;Jason Bau ,&nbsp;Ani Orchanian-Cheff ,&nbsp;S. Joseph Kim","doi":"10.1016/j.trre.2024.100854","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100854","url":null,"abstract":"<div><h3>Background</h3><p>Impact of donor smoking history on kidney transplant recipient outcomes is undefined.</p></div><div><h3>Methods</h3><p>We systematically searched, critically appraised, and summarized associations between donor smoking and primary outcomes of death-censored and all-cause graft failure (DCGF, ACGF), and secondary outcomes of allograft histology, delayed graft function, serum creatinine, estimated glomerular filtration rate, and mortality. We searched MEDLINE, Embase, and Cochrane Databases from 2000 to 2023. Risk of bias was assessed using Risk of Bias in Non-randomized Studies – of Exposure tool. Quality of evidence was assessed by Grading of Recommendations Assessment, Development and Evaluation Working Group recommendations. We pooled results using inverse variance, random-effects model and reported hazard ratios for time-to-event outcomes or binomial proportions. Statistical heterogeneity was assessed with I² statistic.</p></div><div><h3>Results</h3><p>From 1785 citations, we included 17 studies. Donor smoking was associated with modestly increased DCGF (HR 1.05 (95% CI: 1.01, 1.09); I² = 0%; low quality of evidence), predominantly in deceased donors, and ACGF in adjusted analyses (HR 1.12 (95% CI: 1.06, 1.19); I² = 20%; very low quality of evidence). Other outcomes could not be pooled meaningfully.</p></div><div><h3>Conclusions</h3><p>Kidney donor smoking history was associated with modestly increased risk of death-censored graft failure and all-cause graft failure. This review emphasizes the need for further research, standardized reporting, and thoughtful consideration of donor factors like smoking in clinical decision-making on kidney utilization and allocation.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100854"},"PeriodicalIF":4.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000375/pdfft?md5=5f92359369b9f0a731b3f70e9d0069e9&pid=1-s2.0-S0955470X24000375-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140543030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return of the cold: How hypothermic oxygenated machine perfusion is changing liver transplantation","authors":"Charles W.G. Risbey ,&nbsp;Ngee-Soon Lau ,&nbsp;Anita Niu ,&nbsp;Wesley B. Zhang ,&nbsp;Michael Crawford ,&nbsp;Carlo Pulitano","doi":"10.1016/j.trre.2024.100853","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100853","url":null,"abstract":"<div><p>Hypothermic Oxygenated machine PErfusion (HOPE) has recently emerged as a preservation technique which can reduce ischemic injury and improve clinical outcomes following liver transplantation. First developed with the advent solid organ transplantation techniques, hypothermic machine perfusion largely fell out of favour following the development of preservation solutions which can satisfactorily preserve grafts using the cheap and simple method, static cold storage (SCS). However, with an increasing need to develop techniques to reduce graft injury and better utilise marginal and donation after circulatory death (DCD) grafts, HOPE has emerged as a relatively simple and safe technique to optimise clinical outcomes following liver transplantation. Perfusing the graft with cold, acellular, oxygenated perfusate either via the portal vein (PV) alone, or via both the PV and hepatic artery (HA), HOPE is generally commenced for a period of 1–2 h immediately prior to implantation. The technique has been validated by multiple randomised control trials, and pre-clinical evidence suggests HOPE primarily reduces graft injury by decreasing the accumulation of harmful mitochondrial intermediates, and subsequently, the severity of post-reperfusion injury. HOPE can also facilitate real time graft assessment, most notably via the measurement of flavin mononucleotide (FMN) in the perfusate, allowing transplant teams to make better informed clinical decisions prior to transplantation. HOPE may also provide a platform to administer novel therapeutic agents to ex situ organs without risk of systemic side effects. As such, HOPE is uniquely positioned to revolutionise how liver transplantation is approached and facilitate optimised clinical outcomes for liver transplant recipients.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100853"},"PeriodicalIF":4.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140533570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}