A meta‐analysis of perfusion parameters affecting weight gain in ex vivo perfusion

Background Ex vivo machine perfusion (EVMP) has been established to extend viability of donor organs. However, EVMP protocols are inconsistent. We hypothesize that there is a significant relationship between specific parameters during EVMP and perfusion outcomes. Methods A meta‐analysis of literatur...

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Vydáno v:Artificial organs Ročník 49; číslo 1; s. 7 - 20
Hlavní autoři: Marlar, Riley, Abbas, Fuad, Obeid, Rommy, Frisbie, Sean, Ghazoul, Adam, Rezaee, Ava, Sims, Jack, Rampazzo, Antonio, Bassiri Gharb, Bahar
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Wiley Subscription Services, Inc 01.01.2025
John Wiley and Sons Inc
Témata:
Cold flow
Colloids
Erythrocytes
ex vivo
ex vivo machine perfusion
ex vivo organ perfusion
ex‐situ perfusion
ex‐vivo perfusion
Flow velocity
Hemoglobin
Humans
Ischemia
Low flow
machine perfusion
Meta-analysis
Organ Preservation - methods
Organ Preservation Solutions
Oxygen
Parameters
Perfusion
Perfusion - methods
preservation
Systematic Review
Weight
Weight Gain
preservation
ex‐situ perfusion
ex‐vivo perfusion
machine perfusion
perfusion
ex vivo organ perfusion
weight gain
ex vivo
ex vivo machine perfusion
ISSN:0160-564X, 1525-1594, 1525-1594
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Shrnutí:Background Ex vivo machine perfusion (EVMP) has been established to extend viability of donor organs. However, EVMP protocols are inconsistent. We hypothesize that there is a significant relationship between specific parameters during EVMP and perfusion outcomes. Methods A meta‐analysis of literature was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA) Statement. The search encompassed articles published before July 25, 2023. PubMed, Embase, and CENTRAL databases were screened using search terms “ex‐vivo,” “ex‐situ,” “machine,” and “perfusion.” Weight gain, an indicator of organ viability, was chosen to compare outcomes. Extracted variables included perfused organ, warm and cold ischemia time before perfusion, perfusion duration, perfusate flow, pressure, temperature, perfusate composition (presence of cellular or acellular oxygen carrier, colloids, and other supplements) and percent weight change. Data were analyzed using SPSS statistical software. Results Overall, 44 articles were included. Red blood cell‐based perfusates resulted in significantly lower weight gain compared to acellular perfusates without oxygen carriers (11.3% vs. 27.0%, p < 0.001). Hemoglobin‐based oxygen carriers resulted in significantly lower weight gain compared to acellular perfusates (16.5% vs. 27%, p = 0.006). Normothermic perfusion led to the least weight gain (14.6%), significantly different from hypothermic (24.3%) and subnormothermic (25.0%) conditions (p < 0.001), with no significant difference between hypothermic and subnormothermic groups (24.3% vs. 25.0%, p = 0.952). There was a positive correlation between flow rate and weight gain (ß = 13.1, R = 0.390, p < 0.001). Conclusions Oxygen carriers, low flow rates, and normothermic perfusate temperature appear to improve outcomes in EVMP. These findings offer opportunities for improving organ transplantation outcomes. Oxygen carriers, lower flow rates, and normothermic perfusate temperature appear to improve outcomes in ex vivo machine perfusion.
Bibliografie:ObjectType-Article-1
ObjectType-Evidence Based Healthcare-3
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ObjectType-Review-4
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ObjectType-Undefined-3
ISSN:0160-564X
1525-1594
1525-1594
DOI:10.1111/aor.14841