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Presentations and Abstracts
October 20 from 2:30 pm to 2:35 pm in 201-204 Level 2 South: Results of the First 100 Cases of Hypothermic Oxygenated Perfusion in Liver Transplantation in a Portuguese Liver Transplant Center: Maria João Amaral, Mariana Duque, Júlio Constantino, Ricardo Martins, Pedro Oliveira, João Simões, António Pinho, Emanuel Furtado, José Guilherme Tralhão, Dulce Diogo General Surgery Department – Unidade Local de Saúde de Coimbra, Portugal
Introduction: Machine perfusion is a novel method aimed at optimizing livers before transplantation. Hypothermic oxygenated perfusion (HOPE) presents promising results in terms of lower incidence of complications and allows maximizing the use of donors with extended criteria.
Methods: Between August 2020 and July 2023, HOPE was efficiently used in 100 cases in our Center. We analyzed data from the donor, graft and recipient, and from the intra and postoperative period. Furthermore, the development of non-anastomotic strictures (NAS) was analyzed after excluding patients with arterial complications and biliary cast syndrome.
Results: Recipients: age 62 years(IQR 55-66), NELD-Na 17(IQR 11-24), transplanted for HCC in 44% of cases, 6% retransplanted. Donors: age 72 years(IQR 60.5-76.5) (18% age >80 years), BMI of 26.62 Kg/m2(IQR 24.30-29.07), 100% brain dead, BAR score 7(IQR 4-9). Median CIT of 231.5 minutes(IQR 192.5-258.5), 130 minutes(IQR 120.0-152.50) of hypothermic oxygenation. There were 7 cases of post reperfusion syndrome and 1 case of primary graft failure. Peak AST 778.5 U/L(IQR 506.75-1606.0), peak ALT 657.5 U/L(IQR 386.75-1222.0), TB 1.5 mg/dL(IQR 0.9-3.0) and INR 1.12(IQR 1.06-1.23), with 17 cases of early graft dysfunction (of these, none have lost the graft). There were 2 cases of severe ischemia-reperfusion injury. NAS incidence was 6.98%(N=86) and 7.69% for cases with follow-up >6 months(N=65) (previously estimated at 16.9% in our Center).
Conclusion: HOPE increased the use of marginal grafts and we highlight the good function of the grafts in the immediate postoperative period. In addition, there was a decrease in the NAS rate in our Center.
