Reperfusion of liver graft during transplantation: techniques used in transplant centres within Eurotransplant and meta‐analysis of the literature. (21st March 2013)

• Record Type: Journal Article
• Authors: Manzini, Giulia; Kremer, Michael; Houben, Philipp; Gondan, Matthias; Bechstein, Wolf O.; Becker, Thomas; Berlakovich, Gabriela A.; Friess, Helmut; Guba, Markus; Hohenberger, Werner; Ijzermans, Jan N. M.; Jonas, Sven; Kalff, Jörg C.; Klar, Ernst; Klempnauer, Jürgen; Lerut, Jan; Lippert, Hans; Lorf, Thomas; Nadalin, Silvio; Nashan, Björn; Otto, Gerd; Paul, Andreas; Pirenne, Jacques; Pratschke, Johann; Ringers, Jan; Rogiers, Xavier; Schilling, Martin K.; Seehofer, Daniel; Senninger, Norbert; Settmacher, Utz; Stippel, Dirk L.; Tscheliessnigg, Karlheinz; Ysebaert, Dirk; Binder, Heidrun; Schemmer, Peter;
• Is Part Of: Transplant international. Volume 26:Number 5(2013:May)
• Page Start: 508
• Page End: 516
• Publication Date: 2013-03-21
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95405
• DOI: 10.1111/tri.12083
• Languages: English
• ISSNs: 0934-0874

Abstract

<abstract abstract-type="main" id="tri12083-abs-0001"> <title>Summary</title> <p>It remains unclear which liver graft reperfusion technique leads to the best outcome following transplantation. An online survey was sent to all transplant centres (<italic>n</italic> = 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.</p> </abstract>