Evidence map›Paper›PMID 29670285›Full record

Trial reportNature2018

A randomized trial of normothermic preservation in liver transplantation.

David Nasralla, Constantin C Coussios, Hynek Mergental, M Zeeshan Akhtar, Andrew J Butler, Carlo D L Ceresa, Virginia Chiocchia, Susan J Dutton, Juan Carlos García-Valdecasas, Nigel Heaton and 22 more

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Nature, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03930459 (Clinical Trial to Compare the Efficacy of Ex-situ Normothermic Perfusion With Cold Storage in the Transplant With Steatotic Liver Graft.), which is not on this map. Cited by 528 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
528citing papers in PubMed, 6 pooled it
116.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03930459 naterminatednot on this mapstarted 2019, after this paper: background citation

Clinical Trial to Compare the Efficacy of Ex-situ Normothermic Perfusion With Cold Storage in the Transplant With Steatotic Liver Graft.

TypeinterventionalSponsorInstituto de Investigacion Sanitaria La FeRan2019 to 2023Enrolled7ConditionsLiver TransplantArmsStatic cold storage (SCS), Normothermic machine perfusion (NMP)
3 · Its place in the literature

Who cites it

528 citing papers in PubMed, 6 syntheses or guidelines pooled it, 1,175 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Normothermic Regional Perfusion in Controlled Donation After Circulatory Death Liver Transplantation: A Systematic Review and Meta-Analysis.Transplant international : official journal of the European Society for Organ Transplantation · 2024
    Pooled it
  6. Pooled it
  7. Trial
  8. Effect of Normothermic Machine Perfusion on Glycocalyx Shedding During Liver Transplantation - A Prospective Pilot Study.Transplant international : official journal of the European Society for Organ Transplantation · 2026
    Trial
  9. Review
  10. Article
  11. Review
  12. Review
  13. Article
  14. Current status in paediatric liver transplantation for inherited metabolic diseases.Journal of pediatric gastroenterology and nutrition · 2026
    Review
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Review

468 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

32 authors at 12 institutions in 4 countries.

David NasrallaNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK. david.nasralla@nds.ox.ac.uk.
Constantin C CoussiosInstitute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK. constantin.coussios@eng.ox.ac.uk.
Hynek MergentalQueen Elizabeth Hospital Birmingham, Birmingham, UK.
M Zeeshan AkhtarNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Andrew J ButlerUniversity of Cambridge Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.
Carlo D L CeresaNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Virginia ChiocchiaCentre for Statistics in Medicine, University of Oxford, Oxford, UK.
Susan J DuttonOxford Clinical Trials Research Unit, University of Oxford, Oxford, UK.
Juan Carlos García-ValdecasasDepartment of Hepatobiliopancreatic and Transplant Surgery, Hospital Clinic, Barcelona, Spain.
Nigel HeatonInstitute of Liver Studies, King's College Hospital, London, UK.
Charles ImberDepartment of Hepatopancreatobiliary and Liver Transplant Surgery, Royal Free Hospital, London, UK.
Wayel JassemInstitute of Liver Studies, King's College Hospital, London, UK.
Ina JochmansAbdominal Transplant Surgery, Department of Surgery, University Hospitals Leuven, Leuven, Belgium.
John KaraniInstitute of Liver Studies, King's College Hospital, London, UK.
Simon R KnightNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Peri KocabayogluDepartment of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.
Massimo MalagòDepartment of Hepatopancreatobiliary and Liver Transplant Surgery, Royal Free Hospital, London, UK.
Darius MirzaQueen Elizabeth Hospital Birmingham, Birmingham, UK.
Peter J MorrisNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Arvind PallanDepartment of Radiology, Queen Elizabeth Hospital Birmingham, Birmingham, UK.
Andreas PaulDepartment of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.
Mihai PavelDepartment of Hepatobiliopancreatic and Transplant Surgery, Hospital Clinic, Barcelona, Spain.
M Thamara P R PereraQueen Elizabeth Hospital Birmingham, Birmingham, UK.
Jacques PirenneAbdominal Transplant Surgery, Department of Surgery, University Hospitals Leuven, Leuven, Belgium.
Reena RavikumarNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Leslie RussellOrganOx Limited, Oxford, UK.
Sara UpponiDepartment of Radiology, Addenbrooke's Hospital, Cambridge, UK.
Chris J E WatsonUniversity of Cambridge Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.
Annemarie WeissenbacherNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Rutger J PloegNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Peter J FriendNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK. peter.friend@nds.ox.ac.uk.
Consortium for Organ Preservation in Europe
University of Oxford · GBQueen Elizabeth Hospital Birmingham · GBKing's College Hospital · GBEssen University Hospital · DEHospital Clínic de Barcelona · ESKU Leuven · BEUniversity College London · GBUniversity of Cambridge · GBAddenbrooke's Hospital · GBNuffield Orthopaedic Centre · GBOrganOx (United Kingdom) · GBScience Oxford · GB

Funding

Medical Research Council MR/P001734/1
6 · The paper itself

Abstract

Liver transplantation is a highly successful treatment, but is severely limited by the shortage in donor organs. However, many potential donor organs cannot be used; this is because sub-optimal livers do not tolerate conventional cold storage and there is no reliable way to assess organ viability preoperatively. Normothermic machine perfusion maintains the liver in a physiological state, avoids cooling and allows recovery and functional testing. Here we show that, in a randomized trial with 220 liver transplantations, compared to conventional static cold storage, normothermic preservation is associated with a 50% lower level of graft injury, measured by hepatocellular enzyme release, despite a 50% lower rate of organ discard and a 54% longer mean preservation time. There was no significant difference in bile duct complications, graft survival or survival of the patient. If translated to clinical practice, these results would have a major impact on liver transplant outcomes and waiting list mortality.

Indexed as

TemperatureAdolescentAdultAgedAged, 80 and overAllograftsBile DuctsFemaleGraft SurvivalHumansLength of StayLiverLiver TransplantationMaleMiddle AgedOrgan Preservation

Identifiers

PMID29670285
OpenAlexW2797665619

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.