Evidence map›Paper›PMID 39291684›Full record

ArticleArtificial organs2025

Perfusate hemoglobin during normothermic liver machine perfusion as biomarker of early allograft dysfunction: A pilot study.

Akinori Maeda, Graham Starkey, Sofia Spano, Anis Chaba, Glenn Eastwood, Osamu Yoshino, Marcos Vinicius Perini, Michael Fink, Rinaldo Bellomo, Robert Jones

Abstract read
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Article in Artificial organs, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Akinori MaedaDepartment of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia.ORCID https://orcid.org/0009-0004-7388-9450
Graham StarkeyVictorian Liver Transplant Unit, Austin Hospital, Melbourne, Victoria, Australia.
Sofia SpanoDepartment of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia.
Anis ChabaDepartment of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia.
Glenn EastwoodDepartment of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia.
Osamu YoshinoVictorian Liver Transplant Unit, Austin Hospital, Melbourne, Victoria, Australia.
Marcos Vinicius PeriniVictorian Liver Transplant Unit, Austin Hospital, Melbourne, Victoria, Australia.
Michael FinkVictorian Liver Transplant Unit, Austin Hospital, Melbourne, Victoria, Australia.
Rinaldo BellomoDepartment of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia.
Robert JonesVictorian Liver Transplant Unit, Austin Hospital, Melbourne, Victoria, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNormothermic machine perfusion (NMP) aims to reduce ischemia-reperfusion injury in donor livers and its clinical manifestation, early allograft dysfunction (EAD) by maintaining perfusion and oxygenation. However, there is limited data on which NMP perfusate biomarkers might be associated with such EAD and the role of perfusate hemoglobin has not been assessed.

methodsWe performed a pilot retrospective analysis of adult donor livers undergoing NMP between 2020 and 2022 at our center. NMP was commenced at the recipient hospital after initial static cold storage. All NMP circuits were primed in the same manner according to the manufacturer's instructions. Livers were stratified by initial perfusate hemoglobin below (≤5.2 mmol/L) or above (>5.2 mmol/L) the median. The association between hemoglobin levels and EAD or recipient peak transaminase levels was assessed.

resultsAmong 23 livers, eight were considered unsuitable for transplantation, leaving 15 livers for assessment. Higher initial hemoglobin was associated with a lower risk of EAD (0% vs. 55.6%, p = 0.04). Perfusate hemoglobin decreased after NMP initiation (p = 0.003) and negatively correlated with recipient peak transaminase levels (ALT: ρ = -0.72, p = 0.002; AST: ρ = -0.79, p < 0.001). Consistently, higher hemoglobin livers also demonstrated lower perfusate liver enzymes.

conclusionsPerfusate hemoglobin levels decreased during NMP, and lower perfusate hemoglobin levels were associated with a higher incidence of EAD and higher levels of liver injury markers. Maintaining higher hemoglobin levels during NMP may help reduce ischemia-reperfusion injury and prevent or attenuate EAD. Larger prospective studies are needed to validate the findings of this pilot study.

Indexed as

BiomarkersHemoglobinsLiver TransplantationOrgan PreservationPerfusionReperfusion InjuryAdultAgedAllograftsFemaleHumansLiverMaleMiddle AgedPilot ProjectsRetrospective StudiesBiomarkersHemoglobinsearly allograft dysfunctionhemoglobinischemia reperfusion injuryliver transplantationnormothermic liver perfusion

Identifiers

PMID39291684
PMCPMC11687207

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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.