Viability testing of discarded livers with normothermic machine perfusion: Alleviating the organ shortage outweighs the cost.
Viability testing of discarded livers with normothermic machine perfusion: Alleviating the organ shortage outweighs the cost.
复制标题
DOI：
10.1111/ctr.14069
复制
发表时间：
2020-11
影响因子：
2.1
通讯作者：
Yeh H
中科院分区：
文献类型：
--
作者：
Raigani S;De Vries RJ;Carroll C;Chen YW;Chang DC;Shroff SG;Uygun K;Yeh H
在美国，每年有超过700个供体肝脏由于移植功能不良的高风险而被丢弃。本研究的目的是确定使用常温机器灌注的影响，以确定目前丢弃的可移植肝脏。在常温机器灌注期间，对21个丢弃的人肝脏进行了一系列的活力评估。对移植受者科学登记数据库和成本分析进行横断面分析，以将病例系列外推到国家经验。灌注队列中包括21个丢弃的人肝脏。20例合格移植物中有11例（55%）符合移植存活标准。与2017年和2018年新英格兰以外的丢弃移植物（n=1402）相比，灌注队列中的移植物具有相似的供体风险指数（中位数[IQR]：2.0 [1.5，2.4] vs. 2.0 [1.7，2.3]，P=0.40）。自2005年以来，美国每年丢弃705（IQR 677-741）个肝脏，这意味着全国有可能再进行398次移植。通过机器灌注识别可移植物的中位成本为28，099美元。常温机器灌注废弃肝脏可以识别大量的可移植物，显着提高获得肝移植。
Over 700 donor livers are discarded annually in the United States due to high risk of poor graft function. The objective of this study was to determine the impact of using normothermic machine perfusion to identify transplantable livers among those currently discarded. A series of 21 discarded human livers underwent viability assessment during normothermic machine perfusion. Cross-sectional analysis of the Scientific Registry of Transplant Recipients database and cost analysis was performed to extrapolate the case series to national experience. 21 discarded human livers were included in the perfusion cohort. 11 of 20 (55%) eligible grafts met viability criteria for transplantation. Grafts in the perfusion cohort had a similar donor risk index compared to discarded grafts (n=1402) outside of New England in 2017 and 2018 (median [IQR]: 2.0 [1.5, 2.4] vs. 2.0 [1.7, 2.3], P=0.40). 705 (IQR 677–741) livers were discarded annually in the United States since 2005, translating to the potential for 398 additional transplants nationally. The median cost to identify a transplantable graft with machine perfusion was $28,099 USD. Normothermic machine perfusion of discarded livers could identify a significant number of transplantable grafts, significantly improving access to liver transplantation.
登录
查看更多内容
影响因子：
4.6
作者：
Boteon, Yuri L.;Attard, Joseph;Afford, Simon C.
通讯作者：
Afford, Simon C.
影响因子：
7.3
作者：
Laing, Richard W.;Stubblefield, Samantha;Afford, Simon C.
通讯作者：
Afford, Simon C.
影响因子：
8.8
作者：
Linares-Cervantes, Ivan;Echeverri, Juan;Selzner, Markus
通讯作者：
Selzner, Markus
影响因子：
2.9
作者：
Laing RW;Mergental H;Yap C;Kirkham A;Whilku M;Barton D;Curbishley S;Boteon YL;Neil DA;Hübscher SG;Perera MTPR;Muiesan P;Isaac J;Roberts KJ;Cilliers H;Afford SC;Mirza DF
通讯作者：
Mirza DF
影响因子：
46.9
作者：
Eshmuminov, Dilmurodjon;Becker, Dustin;Clavien, Pierre-Alain
通讯作者：
Clavien, Pierre-Alain