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Machine de perfusion normo- ou subnormothermique en transplantation hépatique

Mis en ligne le 14/04/2017

Auteurs : Éric Savier, Olivier Scatton

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  • Les perfusions ex vivo des foies pour transplantation s'inscrivent dans l'approche moderne de la préservation des organes sans qu'aujourd'hui les conditions techniques idéales puissent être établies. Les expériences publiées des perfusions normothermiques par un milieu oxygéné enrichi en globules rouges rapportent une innocuité et une sécurité globale ainsi qu'une possible amélioration des résultats. La complexité de la machine et de la perfusion reste à adapter en fonction de l'objectif : prolongation de la durée de conservation, évaluation de l'organe, reconditionnement du foie, voire correction métabolique. Ces dernières possibilités mettent en lumière des domaines jusqu'alors inexplorés.

Références

1. Brettschneider L, Daloze PM, Huguet C et al. Sucessful orthopic transplantation fo liver homografts after eight to twenty-five hours preservation. Surg Forum 1967;18:376-8.

2. Adam R, Karam V, Delvart V et al. Evolution of indications and results of liver transplantation in Europe. A report from the European Liver Transplant Registry (ELTR). J Hepatol 2012;57(3):75-88.

3. Bruinsma BG, Sridharan GV, Weeder PD et al. Metabolic profiling during ex vivo machine perfusion of the human liver. Sci Rep 2016;6:22415.

4. Karangwa SA, Dutkowski P, Fontes P et al. Machine Perfusion of Donor Livers for Transplantation: A Proposal for Standardized Nomenclature and Reporting Guidelines. Am J Transplant 2016 Apr 29. doi: 10.1111/ajt.13843. [Epub ahead of print]

5. Minor T, Efferz P, Fox M, Wohlschlaeger J, Luer B. Controlled oxygenated rewarming of cold stored liver grafts by thermally graduated machine perfusion prior to reperfusion. Am J Transplant 2013;13(6):1450-60.

6. Hoyer DP, Mathe Z, Gallinat A et al. Controlled Oxygenated Rewarming of Cold Stored Livers Prior to Transplantation: First Clinical Application of a New Concept. Transplantation 2016;100(1):147-152.

7. Perera T, Mergental H, Stephenson B et al. First human liver transplantation using a marginal allograft resuscitated by normothermic machine perfusion. Liver Transpl 2016;22(1):120-4.

8. Olschewski P, Gass P, Ariyakhagorn V et al. The influence of storage temperature during machine perfusion on preservation quality of marginal donor livers. Cryobiology 2010;60(3):337-43.

9. Tolboom H, Izamis ML, Sharma N et al. Subnormothermic machine perfusion at both 20°C and 30°C recovers ischemic rat livers for successful transplantation. J Surg Res 2012;175(1):149-56.

10. Bruinsma BG, Yeh H, Ozer S et al. Subnormothermic machine perfusion for ex vivo preservation and recovery of the human liver for transplantation. Am J Transplant 2014;14(6):1400-9.

11. Spetzler VN, Goldaracena N, Echiverri J et al. Subnormothermic ex vivo liver perfusion is a safe alternative to cold static storage for preserving standard criteria grafts. Liver Transpl 2016;22(1):111-9.

12. Imber CJ, St Peter SD, Lopez de Cenarruzabeitia I et al. Advantages of normothermic perfusion over cold storage in liver preservation. Transplantation 2002;73(5):701-9.

13. Dutkowski P, Schlegel A, de Oliveira M, Mullhaupt B, Neff F, Clavien PA. HOPE for human liver grafts obtained from donors after cardiac death. J Hepatol 2014;60(4):765-72.

14. Guarrera JV, Henry SD, Samstein B et al. Hypothermic machine preservation facilitates successful transplantation of «orphan» extended criteria donor livers. Am J Transplant 2015;15(1):161-9.

15. Nassar A, Liu Q, Farias K et al. Impact of Temperature on Porcine Liver Machine Perfusion From Donors After Cardiac Death. Artif Organs 2016;40(10):999-1008.

16. Schon MR, Kollmar O, Wolf S et al. Liver transplantation after organ preservation with normothermic extracorporeal perfusion. Ann Surg 2001;233(1):114-23.

17. Brockmann J, Reddy S, Coussios C et al. Normothermic perfusion: a new paradigm for organ preservation. Ann Surg 2009;250(1):1-6.

18. Watson CJ, Kosmoliaptsis V, Randle LV et al. Preimplant Normothermic Liver Perfusion of a Suboptimal Liver Donated After Circulatory Death. Am J Transplant 2016;16(1):353-7.

19. Mergental H, Perera MT, Laing RW et al. Transplantation of Declined Liver Allografts Following Normothermic Ex-Situ Evaluation. Am J Transplant 2016(11):3235-45.

20. Athanasopoulos PG, Hadjittofi C, Dharmapala AD et al. Successful Outflow Reconstruction to Salvage Traumatic Hepatic Vein-Caval Avulsion of a Normothermic Machine Ex-Situ Perfused Liver Graft: Case Report and Management of Organ Pool Challenges. Medicine (Baltimore) 2016;95(15):e3119.

21. Liu Q, Nassar A, Farias K et al. Sanguineous normothermic machine perfusion improves hemodynamics and biliary epithelial regeneration in donation after cardiac death porcine livers. Liver Transpl 2014;20(8):987-99.

22. Boehnert MU, Yeung JC, Bazerbachi F et al. Normothermic acellular ex vivo liver perfusion reduces liver and bile duct injury of pig livers retrieved after cardiac death. Am J Transplant 2013;13(6):1441-9.

23. op den Dries S, Karimian N, Sutton ME et al. Ex vivo normothermic machine perfusion and viability testing of discarded human donor livers. Am J Transplant 2013;13(5):1327-35.

24. Selzner M, Goldaracena N, Echeverri J et al. Normothermic ex vivo liver perfusion using steen solution as perfusate for human liver transplantation: First North American results. Liver Transpl 2016;22(11):1501-8.

25. Reddy SP, Bhattacharjya S, Maniakin N et al. Preservation of porcine non-heart-beating donor livers by sequential cold storage and warm perfusion. Transplantation 2004;77(9):
1328-32.

26. Zhang ZB, Gao W, Shi Y et al. Protective role of normothermic machine perfusion during reduced-size liver transplantation in pigs. Liver Transpl 2016;22(7):968-78.

27. Nagrath D, Xu H, Tanimura Y et al. Metabolic preconditioning of donor organs: defatting fatty livers by normothermic perfusion ex vivo. Metab Eng 2009;11(4-5):274-83.

28. Liu Q, Izamis ML, Xu H, Berendsen T, Yarmush M, Uygun K. Strategies to rescue steatotic livers before transplantation in clinical and experimental studies. World J Gastroenterol 2013;19(29):4638-50.

29. Berendsen TA, Bruinsma BG, Puts CF et al. Supercooling enables long-term transplantation survival following 4 days of liver preservation. Nat Med 2014;20(7):790-3.

30. Cypel M, Liu M, Rubacha M et al. Functional repair of human donor lungs by IL-10 gene therapy. Sci Transl Med 2009;1(4):4ra9.

31. Van Raemdonck D, Neyrinck A, Rega F, Devos T, Pirenne J. Machine perfusion in organ transplantation: a tool for ex-vivo graft conditioning with mesenchymal stem cells? Curr Opin Organ Transplant 2013;18(1):24-33.

32. Bral M, Gala-Lopez B, Bigam D et al. Preliminary Single-Centre Canadian Experience of Human Normothermic Ex Vivo Liver Perfusion: Results of a Clinical Trial. Am J Transplant 2016 Sep 17. doi: 10.1111/ajt.14049. [Epub ahead of print]

33. Ravikumar R, Jassem W, Mergental H et al. Liver Transplantation After Ex Vivo Normothermic Machine Preservation: A Phase 1 (First-in-Man) Clinical Trial. Am J Transplant 2016(6);16:1779-87.

Liens d'interêts

É. Savier déclare ne pas avoir de liens d’intérêts.

O. Scatton n’a pas précisé ses éventuels liens d’intérêts.

auteurs
Dr Eric SAVIER

Médecin, Chirurgie viscérale et digestive, Hôpital de la Pitié-Salpêtrière, Paris, France

Contributions et liens d’intérêts
Pr Olivier SCATTON

Médecin, Chirurgie viscérale et digestive, Hôpital de la Pitié-Salpêtrière, Paris, France

Contributions et liens d’intérêts
centre(s) d’intérêt
Transplantation
thématique(s)
Foie
Mots-clés