Hepatocellular Injury Clinical Trial
Official title:
Interest of Oxygenated Hypothermic Perfusion in Preservation of Hepatic Grafts From Expanded Criteria Donors. A Prospective Monocentric Study.
Interest of oxygenated hypothermic perfusion in preservation of hepatic grafts from expanded criteria donors.
The excellent results of liver transplantation (LT) have led to a significant increase in the
number of patients awaiting transplantation. At the same time, the number of grafts remains
stable. To extend the donor pool, the use of Extended Criteria Donor (ECD) donors graft
increased each year despite the fact that these graft are known to be more vulnerable to
ischemia-reperfusion injuries induced by cold storage preservation (CS). Their use is
therefore associated with a greater risk of postoperative dysfunction of the graft. This risk
can be reduced by improving preservation quality.
The preservation by hypothermic oxygenated perfusion (HOPE) consists of keeping the graft in
hypothermia (4 to 12 °C) on an machine perfusion (MP) using a specific solution, saturated
with oxygen. In kidney transplantation, the use of MP has been shown to improve graft
function as well as graft survival, especially for ECD grafts.
In liver transplantation, experimental studies on animal models have demonstrated the
superiority of HOPE over CS regarding graft function and survival. These results have been
confirmed in humans on small retrospective series.
As HOPE is an expensive procedure, obtaining evidence of its effectiveness could result in a
reimbursement of the additional cost.
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