Transplantation Reviews最新文献

{"title":"Brain natriuretic peptide and N-terminal pro b-type natriuretic peptide in kidney transplantation: More than just cardiac markers","authors":"Baris Afsar ,&nbsp;Rengin Elsurer Afsar ,&nbsp;Yasar Caliskan ,&nbsp;Krista L. Lentine","doi":"10.1016/j.trre.2024.100869","DOIUrl":"10.1016/j.trre.2024.100869","url":null,"abstract":"<div><p>Although kidney transplantation (KT) is the best treatment option for most patients with end-stage kidney disease (ESKD) due to reduced mortality, morbidity and increased quality of life, long- term complications such as chronic kidney allograft dysfunction (CKAD) and increased cardiovascular disease burden are still major challenges. Thus, routine screening of KT recipients (KTRs) is very important to identify and quantify risks and guide preventative measures. However, no screening parameter has perfect sensitivity and specificity, and there is unmet need for new markers. In this review, we evaluate brain natriuretic peptide (BNP) and N-terminal pro b-type natriuretic peptide (NT-proBNP) as promising markers for risk stratification in the kidney transplant recipients (KTRs). The usefulness of these markers are already proven in heart failure, hypertension, coronary artery disease. In the context of KT, evidence is emerging. BNP and NT-proBNP has shown to be associated with kidney function, graft failure, echocardiographic parameters, major cardiovascular events and mortality but the underlying mechanisms are not known. Although BNP and NT-proBNP interact with immune system, renin angiotensin system and sympathetic system; it is not known whether these interactions are responsible for the clinical findings observed in KTRs. Future studies are needed whether these biomarkers show clinical efficacy, especially with regard to hard outcomes such as major adverse cardiovascular events and graft dysfunction and whether routine implementation of these markers are cost effective in KTRs.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100869"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444038","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":"Measuring patient-reported experience of solid organ transplantation healthcare: A scoping review of condition- and transplant-specific measures","authors":"Rebeka Jenkins ,&nbsp;Ben Rimmer ,&nbsp;Lorna Marson ,&nbsp;Andrew J. Fisher ,&nbsp;Linda Sharp ,&nbsp;Catherine Exley","doi":"10.1016/j.trre.2024.100872","DOIUrl":"10.1016/j.trre.2024.100872","url":null,"abstract":"<div><h3>Background</h3><p>Measures of patient experience are increasingly valued as key to healthcare quality assessment. We aimed to identify and describe publicly available measures assessing patient-reported experience of solid organ transplantation healthcare, and identify patient groups, healthcare settings, or aspects of patient experience underserved by existing measures.</p></div><div><h3>Methods</h3><p>We systematically searched MEDLINE, Embase, CINAHL, PsycINFO, Cochrane CENTRAL, Scopus and Web of Science from inception to 6th July 2023; supplemented with grey literature searches. Two reviewers independently screened search hits; outputs reporting patient-reported measures of multiple aspects of established solid organ transplantation healthcare were eligible. We abstracted measure context, characteristics, content (i.e., attributes of patient experience assessed), and development and validation processes.</p></div><div><h3>Results</h3><p>We identified nine outputs reporting eight measures of patient experience; these related only to kidney (<em>n</em> = 5) or liver (<em>n</em> = 3) transplantation, with no available measures relating to heart, lung, pancreas or intestinal transplantation. Of the identified measures, four were specific to solid organ transplant recipients. Measures sought to assess “patient satisfaction” (<em>n</em> = 4) and “patient experience” (n = 4) of healthcare. Measures mapped to between five and 16 of 20 attributes of patient experience, most often <em>Information and education</em>, <em>Communication,</em> and <em>Access to care</em> (all <em>n</em> = 7). Six measures reported a development process, only three reported a validation process.</p></div><div><h3>Conclusions</h3><p>Publicly available patient-reported measures of organ transplantation healthcare experiences are limited to kidney and liver transplantation. There is heterogeneity in measure context, characteristics, and content, and insufficient clarity concerning how well measures capture the specific experiences of transplant recipients. Formalised measures of patient experience, specific to solid organ transplantation, with transparent reporting of development and validity are needed.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100872"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000557/pdfft?md5=7aff97411bd1a3e8379bb5a877323594&pid=1-s2.0-S0955470X24000557-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689867","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":"Barriers and facilitators of deceased organ donation among Muslims living globally: An integrative systematic review","authors":"Asmaa Al-Abdulghani ,&nbsp;Britzer Paul Vincent ,&nbsp;Gurch Randhawa ,&nbsp;Erica Cook ,&nbsp;Riadh Fadhil","doi":"10.1016/j.trre.2024.100874","DOIUrl":"10.1016/j.trre.2024.100874","url":null,"abstract":"<div><h3>Aim</h3><p>To identify the barriers and facilitators of deceased organ donation among the Muslim community living globally.</p></div><div><h3>Method</h3><p>A systematic search was undertaken in databases such as CINAHL, Medline with full text, Global Health and PsycINFO via EBSCO; Scopus via Elsevier; Web of Science via Clarivate; and PubMed via US National Library of Medicine National Institute of Health were used to retrieve the studies on the 31st of December 2023. Apart from these databases two other journals, the Saudi Journal of Kidney Diseases and Transplantation, and the Journal of Experimental and Clinical Transplantation were also used to search for relevant studies. Quantitative and qualitative studies that addressed the aim of the present review published from the 30th of April 2008 were included.</p></div><div><h3>Results</h3><p>Of the 10,474 studies, 95 studies were included in the review. The following five themes were generated based on narrative synthesis: 1) knowledge of organ donation, 2) willingness to donate, 3) community influence, 4) bodily influence, and 5) religious influence. While individuals view organ donation as a noble act, societal influences significantly impact their decision to register. Concerns include religious permissibility, potential misuse for commercial purposes, and the dignity and respect given to the deceased donor's body.</p></div><div><h3>Conclusions</h3><p>This review finds deceased organ donation decisions in this population are collective, influenced by religious views, and hindered by uncertainty. Interventional studies on strategies to address uncertainty could help us identify best practices for this population to improve deceased organ donation. Rather than an individual approach among this population, a whole-system approach, tailored-made evidence-guided community engagement could improve donation rates.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100874"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000570/pdfft?md5=17dfd1c068f85138d6c7e54e7dcb56f3&pid=1-s2.0-S0955470X24000570-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879962","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":"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":"2024-07-01","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":"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":"2024-07-01","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":"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":"2024-07-01","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":"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":"2024-07-01","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":"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":"2024-07-01","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":"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":"2024-07-01","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":"2024-07-01","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}