TY - JOUR
T1 - Reperfusion of liver graft during transplantation
T2 - Techniques used in transplant centres within Eurotransplant and meta-analysis of the literature
AU - Manzini, Giulia
AU - Kremer, Michael
AU - Houben, Philipp
AU - Gondan, Matthias
AU - Bechstein, Wolf O.
AU - Becker, Thomas
AU - Berlakovich, Gabriela A.
AU - Friess, Helmut
AU - Guba, Markus
AU - Hohenberger, Werner
AU - Ijzermans, Jan N.M.
AU - Jonas, Sven
AU - Kalff, Jörg C.
AU - Klar, Ernst
AU - Klempnauer, Jürgen
AU - Lerut, Jan
AU - Lippert, Hans
AU - Lorf, Thomas
AU - Nadalin, Silvio
AU - Nashan, Björn
AU - Otto, Gerd
AU - Paul, Andreas
AU - Pirenne, Jacques
AU - Pratschke, Johann
AU - Ringers, Jan
AU - Rogiers, Xavier
AU - Schilling, Martin K.
AU - Seehofer, Daniel
AU - Senninger, Norbert
AU - Settmacher, Utz
AU - Stippel, Dirk L.
AU - Tscheliessnigg, Karlheinz
AU - Ysebaert, Dirk
AU - Binder, Heidrun
AU - Schemmer, Peter
PY - 2013/5
Y1 - 2013/5
N2 - It remains unclear which liver graft reperfusion technique leads to the best outcome following transplantation. An online survey was sent to all transplant centres (n = 37) within Eurotransplant (ET) to collect information on their technique used for reperfusion of liver grafts. Furthermore, a systematic review of all literature was performed and a meta-analysis was conducted based on patients' mortality, number of retransplantations and incidence of biliary complications, depending on the technique used. Of the 28 evaluated centres, 11 (39%) reported performing simultaneous reperfusion (SIMR), 13 (46%) perform initial portal vein reperfusion (IPR), 1 (4%) performs an initial hepatic artery reperfusion (IAR) and 3 (11%) perform retrograde reperfusion (RETR). In 21 centres (75%), one reperfusion technique is used as a standard, but in only one centre is this decision based on available literature. Twenty centres (71%) said they would agree to participate in randomized controlled trials (RCT) if required. For meta-analysis, IAR vs. IPR, SIMR vs. IPR and RETR vs. IPR were compared. There was no difference between any of the techniques compared. There is no consensus on a preferable reperfusion technique. Available evidence does not help in the decision-making process. There is thus an urgent need for multicentric RCTs.
AB - It remains unclear which liver graft reperfusion technique leads to the best outcome following transplantation. An online survey was sent to all transplant centres (n = 37) within Eurotransplant (ET) to collect information on their technique used for reperfusion of liver grafts. Furthermore, a systematic review of all literature was performed and a meta-analysis was conducted based on patients' mortality, number of retransplantations and incidence of biliary complications, depending on the technique used. Of the 28 evaluated centres, 11 (39%) reported performing simultaneous reperfusion (SIMR), 13 (46%) perform initial portal vein reperfusion (IPR), 1 (4%) performs an initial hepatic artery reperfusion (IAR) and 3 (11%) perform retrograde reperfusion (RETR). In 21 centres (75%), one reperfusion technique is used as a standard, but in only one centre is this decision based on available literature. Twenty centres (71%) said they would agree to participate in randomized controlled trials (RCT) if required. For meta-analysis, IAR vs. IPR, SIMR vs. IPR and RETR vs. IPR were compared. There was no difference between any of the techniques compared. There is no consensus on a preferable reperfusion technique. Available evidence does not help in the decision-making process. There is thus an urgent need for multicentric RCTs.
KW - liver reperfusion
KW - retrograde reperfusion
KW - sequential reperfusion
KW - simultaneous reperfusion
UR - https://www.scopus.com/pages/publications/84876475499
U2 - 10.1111/tri.12083
DO - 10.1111/tri.12083
M3 - Article
C2 - 23517278
AN - SCOPUS:84876475499
SN - 0934-0874
VL - 26
SP - 508
EP - 516
JO - Transplant International
JF - Transplant International
IS - 5
ER -