低温氧灌注（HOPE）系统保存肝移植物：单中心经验。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-01-01 DOI:10.1016/j.transproceed.2024.12.006

Beatriz Villota Tamayo , Arkaitz Perfecto Valero , Patricia Ruiz Ordorica , Alberto Ventoso Castiñeira , Gerardo Moro Portela , Jaime Encinas Gutiérrez , Ibone Palomares Etxeberria , Mikel Prieto Calvo , Sara Mambrilla Herrero , Teresa Pascual Vicente , Eunate Muga Ibarreche , María Senosiain Labiano , Mikel Gastaca Mateo

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引用次数: 0

摘要

低温氧灌注（HOPE）系统的开发是为了提高以前认为不理想的肝移植的质量，减少并发症，并增加可用供体的数量。本研究的目的是评估其在我中心肝移植（LT）项目实施以来的结果。材料和方法：我们对2022年8月至2023年11月期间所有患有HOPE的lt进行了回顾性描述性分析，随访时间至少为3个月。适应症标准包括：供体bbb75岁，活检证实大泡性脂肪变性（>30%），供体>70岁，伴有其他危险因素（宏观脂肪变性或肝脏严重次优），预期冷缺血时间>6小时，移植或实验室结果次优的循环死亡后捐赠。结果：在此期间进行的96例LTs中，有12例（12.5%）使用HOPE。2例（16.7%）出现灌注后综合征，1例（8.3%）出现早期同种异体移植物功能障碍。4例（33.3%）患者出现重大手术并发症（Clavien-Dindo≥III），前48小时ALT峰值中位数为438.5 U/L（范围128-2475）。胆道并发症2例（16.7%），静脉并发症1例（8.3%），动脉并发症2例（16.7%）。中位随访7.8个月，患者生存率和移植物生存率均为100%。结论：根据我们的经验，HOPE的使用似乎可以减轻缺血性损伤，并具有良好的中短期效果。

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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Preservation of Liver Graft Using the Hypothermic Oxygenated Perfusion (HOPE) System: A single-center experience

Introduction

The hypothermic oxygenated perfusion (HOPE) system has been developed to improve the quality of previously considered suboptimal liver grafts, reduce complications, and increase the number of available donors. The aim of this study is to evaluate the results since its implementation in the liver transplant (LT) program at our center.

Materials and Methods

We conducted a retrospective descriptive analysis of all LTs with HOPE from August 2022 to November 2023 with a minimum follow-up of 3 months. The indication criteria included: donor >75 years, macrovesicular steatosis (>30%) confirmed by biopsy, donor >70 years with additional risk factors (macroscopic steatosis or grossly suboptimal liver), anticipated cold ischemia time >6 hours, and donation after circulatory death with suboptimal graft or laboratory results.

Results

Of the 96 LTs performed during this period, HOPE was used in 12 cases (12.5%). Two patients (16.7%) experienced postreperfusion syndrome, and one (8.3%) early allograft dysfunction was noted. Four patients (33.3%) had major surgical complications (Clavien-Dindo ≥ III). The median peak of ALT during the first 48 hours was 438.5 U/L (range 128-2475). There were two biliary complications (16.7%), one venous complication (8.3%), and two arterial complications (16.7%). With a median follow-up of 7.8 months, both patient survival and graft survival were 100%.

Conclusion

In our experience, the use of HOPE seems to reduce ischemic damage and shows good short- and medium-term results.

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.