gtag('event', 'click', { 'event_category': 'PDF Download' });
was successfully added to your cart.


Health Professionals BlogLiver Transplantation

Efficiency of machine perfusion in pediatric liver transplantation

Title: Efficiency of machine perfusion in pediatric liver transplantation

Source: Liver Transplantation 2024, Apr 16. [E-publication]

Follow this link

Date of publication: April 2024

Publication type: Review article

Abstract: Liver transplantation is the only lifesaving procedure for children with end-stage liver disease. The field is however heterogenic with various graft types, recipient age and weight and underlying diseases. Despite recently improved overall outcomes and the expanded use of living donors, waiting list mortality remains unacceptable particularly in small children and infants. Based on the known negative effect of elevated donor age, higher body mass index, and prolonged cold ischemia time, the number of available donors for pediatric recipients is limited. Machine perfusion has regained significant interest in the adult liver transplant population during the last decade. Ten randomized controlled trials are published with an overall advantage of machine perfusion techniques over cold storage regarding post-operative outcomes, including graft survival. The concept of hypothermic oxygenated perfusion (HOPE) was the first and only perfusion technique used for pediatric liver transplantation today. In 2018 the first pediatric candidate received a full-size graft donated after circulatory death with cold storage and HOPE, followed by a few split liver transplants after HOPE with an overall limited case number until today. One series of split procedures during HOPE was recently presented by colleagues from France with excellent results, reduced complications, and better graft survival. Such early experience paves the way for a more systematic use of machine perfusion techniques for different graft types for pediatric recipients. Clinical reports of pediatric liver transplants with other perfusion techniques are awaited. Strong collaborative efforts are needed to explore the effect of perfusion techniques in this vulnerable population impacting not only the immediate posttransplant outcome, but the development and success of an entire life.

Leave a Reply

© 2019 Children's Liver Disease Foundation. All Rights Reserved.