Machine Perfusions in Liver Transplantation: The Evidence-Based Position Paper of the Italian Society of Organ and Tissue Transplantation

被引：37

作者：

Ghinolfi, Davide ^{[1
]}

Lai, Quirino ^{[2
]}

Dondossola, Daniele ^{[3
]}

De Carlis, Riccardo ^{[4
]}

Zanierato, Marinella ^{[5
]}

Patrono, Damiano ^{[6
]}

Baroni, Stefano ^{[7
]}

Bassi, Domenico ^{[8
]}

Ferla, Fabio ^{[4
]}

Lauterio, Andrea ^{[4
]}

Lazzeri, Chiara ^{[9
,10
]}

Magistri, Paolo ^{[11
]}

Melandro, Fabio ^{[1
]}

Pagano, Duilio ^{[12
,13
]}

Pezzati, Daniele ^{[1
]}

Ravaioli, Matteo ^{[14
]}

Rreka, Erion ^{[1
]}

Toti, Luca ^{[15
]}

Zanella, Alberto ^{[16
]}

Burra, Patrizia ^{[17
]}

Petta, Salvatore ^{[18
]}

Rossi, Massimo ^{[2
]}

Dutkowski, Philippe ^{[19
]}

Jassem, Wayel ^{[20
]}

Muiesan, Paolo ^{[21
]}

Quintini, Cristiano ^{[22
]}

Selzner, Markus ^{[23
]}

Cillo, Umberto ^{[8
]}

机构：

[1] Univ Pisa, Med Sch Hosp, Div Hepat Surg & Liver Transplantat, Via Paradisa 2, I-56124 Pisa, Italy

[2] Sapienza Univ Rome, Hepatobiliary & Organ Transplantat Unit, Rome, Italy

[3] Univ Milan, Med Sch Hosp, Fdn IRCCS Ca Granda, Gen & Liver Transplantat Unit, Milan, Italy

[4] Osped Niguarda Ca Granda, Dept Gen Surg & Abdominal Transplantat, Milan, Italy

[5] Univ Turin, Med Sch Hosp, Gen Surg & Liver Transplantat, Turin, Italy

[6] Univ Turin, Med Sch Hosp, Dept Anesthesiol, Turin, Italy

[7] Univ Modena, Med Sch Hosp, Dept Anesthesiol, Modena, Italy

[8] Univ Padua, Med Sch Hosp, Hepatobiliary Surg & Liver Transplantat Unit, Padua, Italy

[9] Univ Florence, Med Sch Hosp, Intens Care Unit, Florence, Italy

[10] Univ Florence, Med Sch Hosp, Reg ECMO Referral Ctr, Florence, Italy

[11] Univ Modena, Med Sch Hosp, Transplantat Unit, Hepatopancreatobiliary Surg & Liver, Modena, Italy

[12] Ist Mediterraneo Trapianti & Terapie Alta Special, Dept Treatment & Study Abdominal Dis & Abdominal, Palermo, Italy

[13] Univ Pittsburgh, Med Ctr, Palermo, Italy

[14] Univ Bologna, Med Sch Hosp, Dept Organ Insufficiency & Transplantat, Gen Surg & Transplantat, Bologna, Italy

[15] Univ Tor Vergata, Dept Surg, HPB & Transplant Unit, Rome, Italy

[16] Univ Milan, Med Sch Hosp, Fdn IRCCS Ca Granda, Dept Anesthesia & Crit Care, Milan, Italy

[17] Univ Padua, Med Sch Hosp, Dept Surg Oncol & Gastroenterol, Padua, Italy

[18] Univ Palermo, Med Sch Hosp, Div Gastroenterol & Hepatol, Palermo, Italy

[19] Univ Hosp Zurich, Dept Surg & Transplantat, Zurich, Switzerland

[20] Kings Coll Hosp London, Inst Liver Studies, London, England

[21] Univ Hosp Birmingham NHS Fdn Trust, Queen Elizabeth Hosp, Liver Unit, Birmingham, W Midlands, England

[22] Cleveland Clin, Transplant Ctr, Cleveland, OH 44106 USA

[23] Toronto Gen Hosp, Dept Surg, Multiorgan Transplant Program, Toronto, ON, Canada

来源：

LIVER TRANSPLANTATION | 2020年 / 26卷 / 10期

关键词：

NORMOTHERMIC REGIONAL PERFUSION; HYPOTHERMIC OXYGENATED PERFUSION; CARDIAC DEATH; CIRCULATORY DEATH; TYPE-2; DONATION; DECLINED LIVER; PRESERVATION; ISCHEMIA; DONOR; GRAFTS;

D O I：

10.1002/lt.25817

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

The use of machine perfusion (MP) in liver transplantation (LT) is spreading worldwide. However, its efficacy has not been demonstrated, and its proper clinical use has far to go to be widely implemented. The Societa Italiana Trapianti d'Organo (SITO) promoted the development of an evidence-based position paper. A 3-step approach has been adopted to develop this position paper. First, SITO appointed a chair and a cochair who then assembled a working group with specific experience of MP in LT. The Guideline Development Group framed the clinical questions into a patient, intervention, control, and outcome (PICO) format, extracted and analyzed the available literature, ranked the quality of the evidence, and prepared and graded the recommendations. Recommendations were then discussed by all the members of the SITO and were voted on via the Delphi method by an institutional review board. Finally, they were evaluated and scored by a panel of external reviewers. All available literature was analyzed, and its quality was ranked. A total of 18 recommendations regarding the use and the efficacy of ex situ hypothermic and normothermic machine perfusion and sequential normothermic regional perfusion and ex situ MP were prepared and graded according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. A critical and scientific approach is required for the safe implementation of this new technology.

引用

页码：1298 / 1315

页数：18

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