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SHR Neuro Cancer Cardio Lipid Metab Microb

Hoyer, DP; Mathé, Z; Gallinat, A; Canbay, AC; Treckmann, JW; Rauen, U; Paul, A; Minor, T.
Controlled Oxygenated Rewarming of Cold Stored Livers Prior to Transplantation: First Clinical Application of a New Concept.
Transplantation. 2016; 100(1):147-152 Doi: 10.1097/TP.0000000000000915
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Co-authors Med Uni Graz: Mathe Zoltan
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Abstract:: Abrupt temperature shift from hypothermia to normothermia incurred on reperfusion of organ grafts has been delineated as a genuine factor contributing to reperfusion injury and graft dysfunction after transplantation. In a first clinical series of 6 patients, cold-stored livers, all allocated by the rescue offer mechanism by Eurotransplant, were subjected to machine-assisted slow controlled oxygenated rewarming (COR) for 90 minutes before engrafting. A historical cohort of 106 patients basically similar in graft (all rescue offer organs) and recipient factors was used for comparison. The clinical benefit of COR was documented by a significant reduction by approximately 50% in peak serum transaminases after transplantation compared to untreated controls (AST 563.5 vs. 1204 U/L, P = 0.023). After 6 months graft survival was 100% in the COR group and 80.9% in the controls (P = 0.24). Respective patient survival was 100% and 84.7% (P = 0.28). Real-time assessment of glucose concentration in the perfusion solution correlated well with postoperative synthetic graft function (r = 0.78; P < 0.02). All treated recipients had normal liver function after a 6-month follow-up and are well and alive. This first clinical application suggests that controlled graft rewarming after cold storage is a feasible and safe method in clinical praxis and might become an adjunct in organ preservation.
Find related publications in this database (using NLM MeSH Indexing): Adult -; Aged -; Aged, 80 and over -; Case-Control Studies -; Cold Ischemia - adverse effects; Cold Ischemia - mortality; End Stage Liver Disease - diagnosis; End Stage Liver Disease - mortality; End Stage Liver Disease - surgery; Feasibility Studies -; Female -; Graft Survival -; Hepatectomy -; Humans -; Liver Function Tests -; Liver Transplantation - adverse effects; Liver Transplantation - methods; Liver Transplantation - mortality; Male -; Middle Aged -; Oxygen - adverse effects; Oxygen - therapeutic use; Perfusion - adverse effects; Perfusion - methods; Perfusion - mortality; Postoperative Complications - etiology; Postoperative Complications - mortality; Prospective Studies -; Rewarming - adverse effects; Rewarming - methods; Rewarming - mortality; Risk Factors -; Time Factors -; Treatment Outcome -