Transplant Trial Watch

Liver Preservation by Aortic Perfusion Alone Compared With Preservation by Aortic Perfusion and Additional Arterial Ex Situ Back-Table Perfusion With Histidine-Tryptophan-Ketoglutarate Solution: A Prospective, Randomized, Controlled, Multicenter Study.

Otto G, Heise M, et al.

Transplantation Direct 2017; 3(7): e183.


Aims
To verify whether arterial ex situ back-table perfusion (BP) reduces ischemic-type biliary lesion after liver transplantation.

Interventions
Liver grafts were randomly assigned to be preserved using either standard aortic perfusion (SAP) or SAP + BP.

Participants
150 consecutive full-size liver grafts procured between October 2007 and March 2010 from brain-dead donors aged 15-85 years in the Mitte and Nord regions of Germany.

Outcomes
The primary outcome measured was the incidence of ischemic-type biliary lesions. Secondary outcomes included graft survival, initial graft damage reflected by transaminase levels, functional biliary parameters and serious adverse events.

Follow-up
2 years

CET Conclusions
In this study additional backtable arterial perfusion did not reduce Ischaemic Type Biliary Lesions in DBD livers. The aortic perfusion was done with 10 litres of HTK and, if given, an additional 300ml was used on the backtable. Transaminase levels 3 days after transplantation were also no different, as were graft and patient survival rates. Only 10 of the 33 radiological ITBL were symptomatic. The study was not blinded and the method of randomisation is not recorded. The study was powered adequately for the primary outcome.

Jadad score
3

Data analysis
Per protocol analysis

Alocation concealment
Yes

Trial registration
ISRCTN- 78500982

Funding source
Non-industry funded