Evidence map›Paper›PMID 39448795›Full record

ArticleCommunications medicine2024

A reproducible extended ex-vivo normothermic machine liver perfusion protocol utilising improved nutrition and targeted vascular flows.

George Clarke, Jingwen Mao, Angus Hann, Yiyu Fan, Amita Gupta, Anisa Nutu, Erwin Buckel Schaffner, Kayani Kayani, Nicholas Murphy, Mansoor N Bangash and 7 more

Erratum issuedAbstract read
In one paragraph

Article in Communications medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

George ClarkeLiver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, UK. George.Clarke@uhb.nhs.uk.
Jingwen MaoBirmingham Biomedical Research Centre, National Institute for Health Research (NIHR), University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK.ORCID http://orcid.org/0000-0001-7467-8461
Angus HannLiver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, UK.
Yiyu FanBirmingham Biomedical Research Centre, National Institute for Health Research (NIHR), University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK.
Amita GuptaOchre-Bio Ltd, Oxford, UK.
Anisa NutuLiver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, UK.
Erwin Buckel SchaffnerLiver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, UK.
Kayani KayaniBirmingham Biomedical Research Centre, National Institute for Health Research (NIHR), University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK.ORCID http://orcid.org/0000-0002-8122-3139
Nicholas MurphyIntensive Care Unit, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, UK.ORCID http://orcid.org/0000-0001-8074-1447
Mansoor N BangashIntensive Care Unit, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, UK.ORCID http://orcid.org/0000-0001-5039-5184
Anna L CaseyMicrobiology Department, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, UK.
Isla WoottonClinical Biochemistry, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, UK.
Alexander J LawsonClinical Biochemistry, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, UK.
Bobby V M DasariLiver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, UK.
M Thamara P R PereraLiver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, UK.
Hynek MergentalLiver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, UK.
Simon C AffordBirmingham Biomedical Research Centre, National Institute for Health Research (NIHR), University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK.

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundNormothermic machine perfusion of donor livers has become standard practice in the field of transplantation, allowing the assessment of organs and safe extension of preservation times. Alongside its clinical uses, there has been expanding interest in extended normothermic machine perfusion (eNMP) of livers as a potential vehicle for medical research. Reproducible extended normothermic machine perfusion has remained elusive due to its increased complexity and monitoring requirements. We set out to develop a reproducible protocol for the extended normothermic machine perfusion of whole human livers.

methodsHuman livers declined for transplantation were perfused using a blood-based perfusate at 36 °C using the Liver Assist device (XVIVO, Sweden), with continuous veno-venous haemofiltration in-parallel. We developed the protocol in a stepwise fashion.

resultsPerfusion techniques utilised included: targeted physiological vascular flows, phosphate replacement (to prevent hypophosphataemia), N-acetylcysteine (to prevent methaemoglobin accumulation), and the utilisation of sodium lactate as both a nutritional source and real-time measure of hepatocyte function. All five human livers perfused with the developed protocol showed preserved function with a median perfusion time of 168 h (range 120-184 h), with preserved viability throughout.

conclusionsLivers can be reproducibly perfused in excess of 120 (range 121-184) hours with evidence of preserved hepatocyte and cholangiocyte function.

Identifiers

PMID39448795
PMCPMC11502869

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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.