Academic Journal
Discarded livers tested by normothermic machine perfusion in the VITTAL trial: Secondary end points and 5-year outcomes.
| العنوان: | Discarded livers tested by normothermic machine perfusion in the VITTAL trial: Secondary end points and 5-year outcomes. |
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| المؤلفون: | Mergental, H, Laing, RW, Kirkham, AJ, Clarke, G, Boteon, YL, Barton, D, Neil, DAH, Isaac, JR, Roberts, KJ, Abradelo, M, Schlegel, A, Dasari, BVM, Ferguson, JW, Cilliers, H, Morris, C, Friend, PJ, Yap, C, Afford, SC, Perera, MTPR, Mirza, DF |
| المساهمون: | Yap, Christina |
| بيانات النشر: | LIPPINCOTT WILLIAMS & WILKINS |
| سنة النشر: | 2024 |
| المجموعة: | The Institute of Cancer Research (ICR): Publications Repository |
| مصطلحات موضوعية: | Humans, Aged, Liver Transplantation, Prospective Studies, Constriction, Pathologic, Quality of Life, Liver, Perfusion, Organ Preservation |
| جغرافية الموضوع: | United States |
| الوصف: | Normothermic machine perfusion (NMP) enables pretransplant assessment of high-risk donor livers. The VITTAL trial demonstrated that 71% of the currently discarded organs could be transplanted with 100% 90-day patient and graft survivals. Here, we report secondary end points and 5-year outcomes of this prospective, open-label, phase 2 adaptive single-arm study. The patient and graft survivals at 60 months were 82% and 72%, respectively. Four patients lost their graft due to nonanastomotic biliary strictures, one caused by hepatic artery thrombosis in a liver donated following brain death, and 3 in elderly livers donated after circulatory death (DCD), which all clinically manifested within 6 months after transplantation. There were no late graft losses for other reasons. All the 4 patients who died during the study follow-up had functioning grafts. Nonanastomotic biliary strictures developed in donated after circulatory death livers that failed to produce bile with pH >7.65 and bicarbonate levels >25 mmol/L. Histological assessment in these livers revealed high bile duct injury scores characterized by arterial medial necrosis. The quality of life at 6 months significantly improved in all but 4 patients suffering from nonanastomotic biliary strictures. This first report of long-term outcomes of high-risk livers assessed by normothermic machine perfusion demonstrated excellent 5-year survival without adverse effects in all organs functioning beyond 1 year (ClinicalTrials.gov number NCT02740608). |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | Print-Electronic; 45; application/pdf |
| اللغة: | English |
| تدمد: | 1527-6465 1527-6473 |
| Relation: | 01445473-202401000-00007; Liver Transplantation, 2024, 30 (1), pp. 30 - 45; https://repository.icr.ac.uk/handle/internal/6125 |
| DOI: | 10.1097/LVT.0000000000000270 |
| الاتاحة: | https://repository.icr.ac.uk/handle/internal/6125 https://doi.org/10.1097/LVT.0000000000000270 |
| Rights: | http://creativecommons.org/licenses/by/4.0/ |
| رقم الانضمام: | edsbas.6A0D9DEB |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 15276465 15276473 |
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| DOI: | 10.1097/LVT.0000000000000270 |