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Rachel Soon, 3 days ago

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Hypothermic oxygenated perfusion improves DCD livers for transplantation

24 Dec 2018
Patients with a higher MELD score are given priority for a liver transplant.

Hypothermic oxygenated perfusion (HOPE)-treated human livers donated after circulatory death (DCD) show superior function over untreated livers, a new study has shown.

Researchers evaluated 50 HOPE-treated DCD, 50 donated after brain death (DBD) and 50 untreated DCD liver transplants. Study endpoints included post-transplant complications, nontumour related patient death and graft loss.

Untreated DCD livers required significantly more median transfusions of fresh frozen plasma (6 vs 0; p<0.0001) during operation despite a comparable duration of surgery. HOPE-treated DCD transplants also resulted in a significantly lower lactate level at the end of the transplantation procedure (p<0.0001).

International normalized ratio (INR)1 day after transplantation was likewise significantly reduced in those who received the HOPE-treated DCD livers (p<0.0001). These findings indicated superior function over untreated transplants. There was no between-group difference in peak 7-day alanine aminotransferase release.

In terms of complications, acute rejections were significantly more common in untreated DCD livers relative to HOPE-treated transplants (p=0.0019). Median alkaline phosphatase levels 6 months after the procedure were similarly significantly lower in those who received the treated livers (p=0.049).

Seven cases of graft loss were reported in the untreated DCD group, which was significantly greater than that in the HOPE-treated transplant group (n=0; p=0.0125). Ischaemic cholangiopathy and primary nonfunction were the reasons for graft loss.

Five-year graft survival rates for the untreated and HOPE-treated DCD livers were 74 percent and 94 percent, respectively. HOPE-treated transplants demonstrated comparable overall survival compared with DBD controls.

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Most Read Articles
Rachel Soon, 3 days ago

Gels utilizing Stichopus horrens (golden sea cucumber/gamat) extract show a similar efficacy to standard-of-care hydrogels for promoting wound healing, according to a prospective study.

16 Mar 2019
Sleep difficulties are exacerbated in long-term survivors of childhood cancers, which may lead to persistent emotional distress, a new study has found.
2 days ago
Higher cancer symptom burden in elderly adults is associated with functional impairment, reports a recent study.
Jairia Dela Cruz, 5 days ago
Use of mirabegron in the treatment of men with overactive bladder (OAB) appears to effectively alleviate urgency and storage symptoms, but not reduce the frequency of micturition episodes, according to data from the MIRACLE study.