Extending Horizons in Abdominal Transplantation – An XVIVO industry symposia, ESOT 2021
The topics covered the current strategies of perfusion that are applied during clinical ex vivo isolated organ perfusions.
Prof. Ina Jochmans (Leuven, Belgium), member of the COPE-consortium (Consortium on Organ Preservation in Europe) spoke as the Principal Investigator of the COMPARE multi-centre trial which shows benefits for oxygenated perfusion of donor kidneys derived from DCD donors. The study compared hypothermic machine perfusion with and without oxygen. In the group with 100% active oxygenation, kidney function was improved, graft failure was prevented, and graft rejection was significantly reduced. The study was performed on Kidney Assist Transport device and the results were published in The Lancet.
Prof. Philipp Dutkowski (Zürich, Switzerland) presented (preliminary) results of his randomized controlled trial on HOPE (Hypothermic Oxygenated Perfusion). The most important findings were the prevention of complications after transplant and reduction of biliary complications.
Dr. Georg Lurje (Charité Berlin, Germany) showed preliminary results of the randomized controlled multi-center trial of HOPE ECD livers. Even in this category of donors the livers enrolled in the trial showed better results after hypothermic oxygenated perfusion. Furthermore, the group of Lurje was able to produce numbers that support cost-effectiveness of hypothermic liver perfusion. The results of the trial have been recently published in the Annals of Surgery.
The combination of hypothermic perfusion with normothermic perfusion for livers was introduced by Prof. Robert Porte (UMCG Groningen, The Netherlands). The protocol combines the two possible ways for liver perfusion; first one hour of dHOPE (dual Hypothermic Oxygenated Perfusion) subsequently followed by one hour of slow rewarming towards 37 degrees Celsius. Initially declined livers were perfused in a normothermic condition for a period upto 6 hours. The most important indicator for graft viability identified in the clinical trial was the difference between bile pH and perfusate pH. This combination of dHOPE, rewarming and normothermic evaluation allowed them to recover about 70% of the previously declined livers without major biliary complications that led to re-transplantation, and reached a survival rate after 1 year of 100%.
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The scientific programme is available on ESOT virtual platform follow this link to learn more about presentations and discussions that took place in Milan, please visit: https://www.esotcongress.org/.
Click here to watch the animated summary of the COMPARE trial.
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