[en] Static Cold Storage (SCS) injures the bile duct, while the effect of Normothermic Machine Perfusion (NMP) is unknown. In a sub-study of the COPE trial on liver NMP, we investigated the impact of preservation type on histological bile duct injury score (BDIS). Transplants with at least one bile duct biopsy, either at end of preservation or 1 h post-reperfusion, were considered. BDIS was determined by assessing peribiliary glands injury, stromal and mural loss, haemorrhage, and thrombosis. A bivariate linear model compared BDIS (estimate, CI) between groups. Sixty-five transplants and 85 biopsies were analysed. Twenty-three grafts were preserved with SCS and 42 with NMP, with comparable baseline characteristics except for a shorter cold ischemic time in NMP. The BDIS increased over time regardless of preservation type (p = 0.04). The BDIS estimate was higher in NMP [8.02 (7.40-8.65)] than in SCS [5.39 (4.52-6.26), p < 0.0001] regardless of time. One patient in each group developed ischemic cholangiopathy, with a BDIS of 6 for the NMP-preserved liver. In six other NMP grafts, BDIS ranged 7-12 without development of ischemic cholangiopathy. In conclusion, BDIS increases over time, and the higher BDIS in NMP did not increase ischemic cholangiopathy. Thus, BDIS may overestimate this risk after liver NMP.
Disciplines :
Surgery
Author, co-author :
Gilbo, NICHOLAS ; Centre Hospitalier Universitaire de Liège - CHU > > Service de chirurgie abdo, sénologique, endocrine et de transplantation ; Laboratory of Abdominal Transplantation, Department of Microbiology, Immunology and Transplantation, Faculty of Medicine, KU Leuven, Leuven, Belgium
Neil, Desley; Department of Cellular Pathology, Queen Elizabeth Hospital, Birmingham, United Kingdom
Brais, Rebecca; Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
Fieuws, Steffen; Interuniversity Center for Biostatistics and Statistical Bioinformatics, UZ KU Leuven, Leuven, Belgium
Lo Faro, Letizia; Oxford Transplant Centre, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
Friend, Peter; Oxford Transplant Centre, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
Ploeg, Rutger; Oxford Transplant Centre, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
Monbaliu, Diethard; Laboratory of Abdominal Transplantation, Department of Microbiology, Immunology and Transplantation, Faculty of Medicine, KU Leuven, Leuven, Belgium ; Transplantation Research Group, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
Language :
English
Title :
The Effect of Continuous Liver Normothermic Machine Perfusion on the Severity of Histological Bile Duct Injury.
Publication date :
2023
Journal title :
Transplant International
ISSN :
0934-0874
eISSN :
1432-2277
Publisher :
European Society for Organ Transplantation, Switzerland
The study was accepted for presentation at ESOT Congress, Athens, 2023. We gratefully acknowledge the patients, donors, and donor families as well as all transplant centres that included livers in this trial. We are indebted to Sarah Mertens, Rajeev Kumar, and Bhumika Patel for help with ethics approval, database management, and sample bio banking. We thank the European Commission for their support through the Seventh Framework Programme.
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