AI Article Synopsis
- Machine perfusion, specifically dual-hypothermic oxygenated machine perfusion (D-HOPE), is being studied for its potential to reduce recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT).
- A retrospective study from 2016 to 2020 compared outcomes between patients who received livers preserved using D-HOPE versus traditional static cold storage (SCS).
- The results showed that D-HOPE did not significantly reduce HCC recurrence rates compared to SCS, but allowed for the use of livers from older, extended criteria donors while maintaining comparable postoperative outcomes.
Article Abstract
Background: Machine perfusion may be able to mitigate ischemia-reperfusion injury (IRI), which increases hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT). This study aimed to investigate the impact of dual-hypothermic oxygenated machine perfusion (D-HOPE) on HCC recurrence in LT.
Methods: A single-center retrospective study was conducted from 2016 to 2020. Pre- and postoperative data of HCC patients undergoing LT were analyzed. Recipients of a D-HOPE-treated graft were compared to those of livers preserved using static cold storage (SCS). The primary endpoint was recurrence-free survival (RFS).
Results: Of 326 patients, 246 received an SCS-preserved liver and 80 received a D-HOPE-treated graft (donation after brain death (DBD), n = 66; donation after circulatory death (DCD), n = 14). Donors of D-HOPE-treated grafts were older and had higher BMI. All DCD donors were treated by normothermic regional perfusion and D-HOPE. The groups were comparable in terms of HCC features and estimated 5-year RFS according to the Metroticket 2.0 model. D-HOPE did not reduce HCC recurrence (D-HOPE 10%; SCS 8.9%; = 0.95), which was confirmed using Bayesian model averaging and inverse probability of treatment weighting-adjusted RFS analysis. Postoperative outcomes were comparable between groups, except for lower AST and ALT peak in the D-HOPE group.
Conclusions: In this single-center study, D-HOPE did not reduce HCC recurrence but allowed utilizing livers from extended criteria donors with comparable outcomes, improving access to LT for patients suffering from HCC.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10220870 | PMC |
| http://dx.doi.org/10.3390/jpm13050703 | DOI Listing |
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