Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May-Jun;14(3):101337.
doi: 10.1016/j.jceh.2023.101337. Epub 2023 Dec 19.

Benefits of Hypothermic Oxygenated Perfusion Versus Static Cold Storage in Liver Transplant: A Comprehensive Systematic Review and Meta-analysis

Guo-Ying Feng  1   2 , Xu Feng  1 , Jie Tao  1 , Yu-Pei Ao  3 , Xin-Hua Wu  1 , Shi-Guai Qi  1 , Ze-Bo He  4 , Zheng-Rong Shi  1
Affiliations

Benefits of Hypothermic Oxygenated Perfusion Versus Static Cold Storage in Liver Transplant: A Comprehensive Systematic Review and Meta-analysis

Guo-Ying Feng et al. J Clin Exp Hepatol. 2024 May-Jun.

Abstract

Background: The magnitude of potential benefits that hypothermic oxygenated perfusion (HOPE) may provide for liver transplantation (LT) patients compared to static cold storage (SCS) remains uncertain. In this systematic review and meta-analysis, we aimed to investigate the therapeutic effect that HOPE can offer LT recipients relative to SCS by synthesizing available evidence.

Methods: A literature search was conducted in Embase, Medline, Web of Science, and the Cochrane database up to 1 June, 2023. The included studies were pooled for meta-analysis to synthesize their findings. Subgroup analysis was performed to investigate potential differences between HOPE and SCS for specific subgroups.

Results: A total of 11 studies comprising 1765 patients were included. Compared with SCS, HOPE was associated with a significant reduction in the incidence of early allograft dysfunction (EAD) (OR: 0.36, 95% CI: 0.26-0.50), as well as a noteworthy decrease in graft loss rate within one year (OR: 0.57, 95% CI: 0.33-0.97) and a lower occurrence of Clavien-Dindo grade IIIa or higher complications (OR: 0.62, 95% CI: 0.43-0.89). Subgroup analysis revealed that HOPE significantly reduced the one-year mortality rate, any biliary complications incidence, and acute rejection of transplanted liver rate in patients who received organs from donation after cardiac death (DCD).

Conclusions: HOPE has demonstrated efficacy in reducing the incidence of EAD after LT and shows some potential in diminishing postoperative complications such as biliary complications and acute rejection. This ultimately leads to improved patient prognosis, particularly among those receiving DCD grafts.

Keywords: donation after cardiac death; hypothermic oxygenated machine perfusion; liver transplantation; meta-analysis; static cold storage.

PubMed Disclaimer

Figures

Image 1
Graphical abstract
Figure 1
Figure 1
Flow diagram of the identification and selection process.
Figure 2
Figure 2
Forest plots of the primary end points. (A) Early allograft dysfunction. (B) Primary non-function. (C) Acute rejection of transplanted liver. (D) Overall graft loss within one year.
Figure 3
Figure 3
Forest plots of the secondary end points. (A) Recipient mortality within one year. (B) Any biliary complications. (C) Any vascular complications.
Figure 4
Figure 4
Forest plots of complications with Clavien-Dindo grading greater than or equal to IIIa or IIIb.
See this image and copyright information in PMC

References

    1. Sousa Da Silva R.X., Weber A., Dutkowski P., Clavien P.A. Machine perfusion in liver transplantation. Hepatology. 2022;76:1531–1549. - PubMed
    1. Terrault N.A., Francoz C., Berenguer M., Charlton M., Heimbach J. Liver Transplantation 2023: Status Report, Current and Future Challenges. Clin Gastroenterol Hepatol. 2023 Jul;21(8):2150–2166. - PubMed
    1. Durand F., Renz J.F., Alkofer B., et al. Report of the Paris consensus meeting on expanded criteria donors in liver transplantation. Liver Transpl. 2008;14:1694–1707. - PubMed
    1. Kalisvaart M., de Haan J.E., Polak W.G., et al. Comparison of postoperative outcomes between donation after circulatory death and donation after brain death liver transplantation using the comprehensive complication index. Ann Surg. 2017;266:772–778. - PubMed
    1. Hessheimer A.J., Coll E., Torres F., et al. Normothermic regional perfusion vs. super-rapid recovery in controlled donation after circulatory death liver transplantation. J Hepatol. 2019;70:658–665. - PubMed

LinkOut - more resources