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Ex-Situ Dual Hypothermic Oxygenated Machine Perfusion in Full-Left-Full-Right Split Liver Transplantation for Two Adult Recipients.

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Název: Ex-Situ Dual Hypothermic Oxygenated Machine Perfusion in Full-Left-Full-Right Split Liver Transplantation for Two Adult Recipients.
Autoři: Kobryń, Konrad, Frankowska, Aleksandra, Rykowski, Paweł, Bartkowiak, Mateusz, Zhylko, Andriej, Morawski, Marcin, Stypułkowski, Jan, Masior, Łukasz, Smoter, Piotr, Patkowski, Waldemar, Grąt, Michał
Zdroj: Journal of Clinical Medicine; Sep2025, Vol. 14 Issue 18, p6596, 19p
Témata: LIVER transplantation, REPERFUSION injury, ADULTS, ARTIFICIAL blood circulation, TRANSPLANTATION of organs, tissues, etc., GRAFT survival, PERFUSION
Abstrakt: Background/Objectives: The shortage of liver grafts remains a major challenge in transplantation. Full-left-full-right (FLFR) split liver transplantation (SLT) expands the donor pool by providing two grafts for small adult recipients. However, prolonged cold ischemia time (CIT) and ischemia-reperfusion injury (IRI) limit its success. Methods: We report a case of FLFR SLT utilizing ex situ dual hypothermic oxygenated machine perfusion (DHOPE) to mitigate IRI and enhance graft viability. A brain-dead donor's liver was split under continuous DHOPE, followed by simultaneous transplantation into two adult recipients. Results: Both recipients exhibited stable graft function at one-year follow-up. DHOPE effectively reduced CIT and optimized postoperative recovery, with no major complications beyond Clavien–Dindo Grade IIIb. Conclusions: This is the first reported FLFR SLT using ex situ DHOPE for two adult recipients, demonstrating its feasibility in reducing CIT and improving outcomes. Machine perfusion may become a standard in FLFR SLT. [ABSTRACT FROM AUTHOR]
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Databáze: Biomedical Index
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Abstrakt:Background/Objectives: The shortage of liver grafts remains a major challenge in transplantation. Full-left-full-right (FLFR) split liver transplantation (SLT) expands the donor pool by providing two grafts for small adult recipients. However, prolonged cold ischemia time (CIT) and ischemia-reperfusion injury (IRI) limit its success. Methods: We report a case of FLFR SLT utilizing ex situ dual hypothermic oxygenated machine perfusion (DHOPE) to mitigate IRI and enhance graft viability. A brain-dead donor's liver was split under continuous DHOPE, followed by simultaneous transplantation into two adult recipients. Results: Both recipients exhibited stable graft function at one-year follow-up. DHOPE effectively reduced CIT and optimized postoperative recovery, with no major complications beyond Clavien–Dindo Grade IIIb. Conclusions: This is the first reported FLFR SLT using ex situ DHOPE for two adult recipients, demonstrating its feasibility in reducing CIT and improving outcomes. Machine perfusion may become a standard in FLFR SLT. [ABSTRACT FROM AUTHOR]
ISSN:20770383
DOI:10.3390/jcm14186596