Optimizing Livers for Transplantation Using Machine Perfusion versus Cold Storage in Large Animal Studies and Human Studies: A Systematic Review and Meta-Analysis
Background. Liver allograft preservation frequently involves static cold storage (CS) and machine perfusion (MP). With its increasing popularity, we investigated whether MP was superior to CS in terms of beneficial outcomes. Methods. Human studies and large animal studies that optimized livers for t...
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| creator | Gao, Yi Pan, Mingxin Feng, Lei Jiang, Xinan |
| description | Background. Liver allograft preservation frequently involves static cold storage (CS) and machine perfusion (MP). With its increasing popularity, we investigated whether MP was superior to CS in terms of beneficial outcomes. Methods. Human studies and large animal studies that optimized livers for transplantation using MP versus CS were assessed (PubMed/Medline/EMBASE). Meta-analyses were conducted for comparisons. Study quality was assessed according to the Newcastle-Ottawa quality assessment scale and SYRCLE’s risk of bias tool. Results. Nineteen studies were included. Among the large animal studies, lower levels of lactate dehydrogenase (SMD -3.16, 95% CI -5.14 to -1.18), alanine transferase (SMD -2.46, 95% CI -4.03 to -0.90), and hyaluronic acid (SMD -2.48, 95% CI -4.21 to -0.74) were observed in SNMP-preserved compared to CS-preserved livers. NMP-preserved livers showing lower level of hyaluronic acid (SMD -3.97, 95% CI -5.46 to -2.47) compared to CS-preserved livers. Biliary complications (RR 0.45, 95% CI 0.28 to 0.73) and early graft dysfunction (RR 0.56, 95% CI 0.34 to 0.92) also significantly reduced with HMP preservation in human studies. No evidence of publication bias was found. Conclusions. MP preservation could improve short-term outcomes after transplantation compared to CS preservation. Additional randomized controlled trials (RCTs) are needed to develop clinical applications of MP preservation. |
| doi_str_mv | 10.1155/2018/9180757 |
| format | Article |
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Liver allograft preservation frequently involves static cold storage (CS) and machine perfusion (MP). With its increasing popularity, we investigated whether MP was superior to CS in terms of beneficial outcomes. Methods. Human studies and large animal studies that optimized livers for transplantation using MP versus CS were assessed (PubMed/Medline/EMBASE). Meta-analyses were conducted for comparisons. Study quality was assessed according to the Newcastle-Ottawa quality assessment scale and SYRCLE’s risk of bias tool. Results. Nineteen studies were included. Among the large animal studies, lower levels of lactate dehydrogenase (SMD -3.16, 95% CI -5.14 to -1.18), alanine transferase (SMD -2.46, 95% CI -4.03 to -0.90), and hyaluronic acid (SMD -2.48, 95% CI -4.21 to -0.74) were observed in SNMP-preserved compared to CS-preserved livers. NMP-preserved livers showing lower level of hyaluronic acid (SMD -3.97, 95% CI -5.46 to -2.47) compared to CS-preserved livers. Biliary complications (RR 0.45, 95% CI 0.28 to 0.73) and early graft dysfunction (RR 0.56, 95% CI 0.34 to 0.92) also significantly reduced with HMP preservation in human studies. No evidence of publication bias was found. Conclusions. MP preservation could improve short-term outcomes after transplantation compared to CS preservation. Additional randomized controlled trials (RCTs) are needed to develop clinical applications of MP preservation.</description><identifier>ISSN: 2314-6133</identifier><identifier>EISSN: 2314-6141</identifier><identifier>DOI: 10.1155/2018/9180757</identifier><identifier>PMID: 30255101</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Publishing Corporation</publisher><subject>Alanine ; Analysis ; Animals ; Bias ; Clinical trials ; Cold storage ; Cryopreservation ; Hepatology ; Humans ; Hyaluronic acid ; L-Lactate dehydrogenase ; Laboratory animals ; Lactate dehydrogenase ; Lactic acid ; Liver ; Liver - enzymology ; Liver Transplantation ; Meta-analysis ; Organ Preservation ; Perfusion ; Political aspects ; Preservation ; Quality assessment ; Quality control ; Review ; Rodents ; Studies ; Swine ; Systematic review ; Therapeutic applications ; Transplantation ; Transplants & implants</subject><ispartof>BioMed research international, 2018-01, Vol.2018 (2018), p.1-15</ispartof><rights>Copyright © 2018 Xinan Jiang et al.</rights><rights>COPYRIGHT 2018 John Wiley & Sons, Inc.</rights><rights>Copyright © 2018 Xinan Jiang et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. https://creativecommons.org/licenses/by/4.0</rights><rights>Copyright © 2018 Xinan Jiang et al. 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c499t-56d2300aab544fda887ffcb180764b0aacdf63a682964918678e60e5b0f9221a3</citedby><cites>FETCH-LOGICAL-c499t-56d2300aab544fda887ffcb180764b0aacdf63a682964918678e60e5b0f9221a3</cites><orcidid>0000-0001-6053-8417 ; 0000-0003-3525-0133</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145150/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145150/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30255101$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Leo, Hwa-Liang</contributor><contributor>Hwa-Liang Leo</contributor><creatorcontrib>Gao, Yi</creatorcontrib><creatorcontrib>Pan, Mingxin</creatorcontrib><creatorcontrib>Feng, Lei</creatorcontrib><creatorcontrib>Jiang, Xinan</creatorcontrib><title>Optimizing Livers for Transplantation Using Machine Perfusion versus Cold Storage in Large Animal Studies and Human Studies: A Systematic Review and Meta-Analysis</title><title>BioMed research international</title><addtitle>Biomed Res Int</addtitle><description>Background. Liver allograft preservation frequently involves static cold storage (CS) and machine perfusion (MP). With its increasing popularity, we investigated whether MP was superior to CS in terms of beneficial outcomes. Methods. Human studies and large animal studies that optimized livers for transplantation using MP versus CS were assessed (PubMed/Medline/EMBASE). Meta-analyses were conducted for comparisons. Study quality was assessed according to the Newcastle-Ottawa quality assessment scale and SYRCLE’s risk of bias tool. Results. Nineteen studies were included. Among the large animal studies, lower levels of lactate dehydrogenase (SMD -3.16, 95% CI -5.14 to -1.18), alanine transferase (SMD -2.46, 95% CI -4.03 to -0.90), and hyaluronic acid (SMD -2.48, 95% CI -4.21 to -0.74) were observed in SNMP-preserved compared to CS-preserved livers. NMP-preserved livers showing lower level of hyaluronic acid (SMD -3.97, 95% CI -5.46 to -2.47) compared to CS-preserved livers. Biliary complications (RR 0.45, 95% CI 0.28 to 0.73) and early graft dysfunction (RR 0.56, 95% CI 0.34 to 0.92) also significantly reduced with HMP preservation in human studies. No evidence of publication bias was found. Conclusions. MP preservation could improve short-term outcomes after transplantation compared to CS preservation. Additional randomized controlled trials (RCTs) are needed to develop clinical applications of MP preservation.</description><subject>Alanine</subject><subject>Analysis</subject><subject>Animals</subject><subject>Bias</subject><subject>Clinical trials</subject><subject>Cold storage</subject><subject>Cryopreservation</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Hyaluronic acid</subject><subject>L-Lactate dehydrogenase</subject><subject>Laboratory animals</subject><subject>Lactate dehydrogenase</subject><subject>Lactic acid</subject><subject>Liver</subject><subject>Liver - enzymology</subject><subject>Liver Transplantation</subject><subject>Meta-analysis</subject><subject>Organ Preservation</subject><subject>Perfusion</subject><subject>Political aspects</subject><subject>Preservation</subject><subject>Quality assessment</subject><subject>Quality control</subject><subject>Review</subject><subject>Rodents</subject><subject>Studies</subject><subject>Swine</subject><subject>Systematic review</subject><subject>Therapeutic applications</subject><subject>Transplantation</subject><subject>Transplants & implants</subject><issn>2314-6133</issn><issn>2314-6141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>RHX</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkstu1DAUhiMEolXpjjWyxAYJQn2JPTELpGgEFGmqItqurZPEnrpK7KmdTDV9nD4pDjOdAiu8sfX78398Lln2muCPhHB-QjEpTyQp8YzPnmWHlJEiF6Qgz_dnxg6y4xhvcFolEViKl9kBw5Rzgslh9nC-Gmxv761booVd6xCR8QFdBnBx1YEbYLDeoas4AWfQXFun0Q8dzBgnfXowRjT3XYsuBh9gqZF1aAEhHSpne-iSPrZWRwSuRadjD-5R-YQqdLGJg-5TkAb91Gur735jZ3qAvHLQbaKNr7IXBrqoj3f7UXb19cvl_DRfnH_7Pq8WeVNIOeRctJRhDFDzojAtlOXMmKaeaiOKOulNawQDUVIpilQyMSu1wJrX2EhKCbCj7PPWdzXWvW4b7YYAnVqFlEXYKA9W_X3j7LVa-rVKBeeE42TwbmcQ_O2o46B6GxvdpTJqP0ZFCaGpIRzLhL79B73xY0gJTxQupGCypE_UEjqtrDM-xW0mU1UJSmZSSs4S9WFLNcHHGLTZf5lgNU2JmqZE7aYk4W_-THMPP85EAt5vgdTrFu7sf9qlLqbY8EQTKjnn7BfYes8Y</recordid><startdate>20180101</startdate><enddate>20180101</enddate><creator>Gao, Yi</creator><creator>Pan, Mingxin</creator><creator>Feng, Lei</creator><creator>Jiang, Xinan</creator><general>Hindawi Publishing Corporation</general><general>Hindawi</general><general>John Wiley & Sons, Inc</general><general>Hindawi Limited</general><scope>ADJCN</scope><scope>AHFXO</scope><scope>RHU</scope><scope>RHW</scope><scope>RHX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7QO</scope><scope>7T7</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>CWDGH</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6053-8417</orcidid><orcidid>https://orcid.org/0000-0003-3525-0133</orcidid></search><sort><creationdate>20180101</creationdate><title>Optimizing Livers for Transplantation Using Machine Perfusion versus Cold Storage in Large Animal Studies and Human Studies: A Systematic Review and Meta-Analysis</title><author>Gao, Yi ; Pan, Mingxin ; Feng, Lei ; Jiang, Xinan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c499t-56d2300aab544fda887ffcb180764b0aacdf63a682964918678e60e5b0f9221a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Alanine</topic><topic>Analysis</topic><topic>Animals</topic><topic>Bias</topic><topic>Clinical trials</topic><topic>Cold storage</topic><topic>Cryopreservation</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Hyaluronic acid</topic><topic>L-Lactate dehydrogenase</topic><topic>Laboratory animals</topic><topic>Lactate dehydrogenase</topic><topic>Lactic acid</topic><topic>Liver</topic><topic>Liver - enzymology</topic><topic>Liver Transplantation</topic><topic>Meta-analysis</topic><topic>Organ Preservation</topic><topic>Perfusion</topic><topic>Political aspects</topic><topic>Preservation</topic><topic>Quality assessment</topic><topic>Quality control</topic><topic>Review</topic><topic>Rodents</topic><topic>Studies</topic><topic>Swine</topic><topic>Systematic review</topic><topic>Therapeutic applications</topic><topic>Transplantation</topic><topic>Transplants & implants</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gao, Yi</creatorcontrib><creatorcontrib>Pan, Mingxin</creatorcontrib><creatorcontrib>Feng, Lei</creatorcontrib><creatorcontrib>Jiang, Xinan</creatorcontrib><collection>الدوريات العلمية والإحصائية - e-Marefa Academic and Statistical Periodicals</collection><collection>معرفة - المحتوى العربي الأكاديمي المتكامل - e-Marefa Academic Complete</collection><collection>Hindawi Publishing Complete</collection><collection>Hindawi Publishing Subscription Journals</collection><collection>Hindawi Publishing Open Access Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Middle East & Africa Database</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BioMed research international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gao, Yi</au><au>Pan, Mingxin</au><au>Feng, Lei</au><au>Jiang, Xinan</au><au>Leo, Hwa-Liang</au><au>Hwa-Liang Leo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Optimizing Livers for Transplantation Using Machine Perfusion versus Cold Storage in Large Animal Studies and Human Studies: A Systematic Review and Meta-Analysis</atitle><jtitle>BioMed research international</jtitle><addtitle>Biomed Res Int</addtitle><date>2018-01-01</date><risdate>2018</risdate><volume>2018</volume><issue>2018</issue><spage>1</spage><epage>15</epage><pages>1-15</pages><issn>2314-6133</issn><eissn>2314-6141</eissn><abstract>Background. Liver allograft preservation frequently involves static cold storage (CS) and machine perfusion (MP). With its increasing popularity, we investigated whether MP was superior to CS in terms of beneficial outcomes. Methods. Human studies and large animal studies that optimized livers for transplantation using MP versus CS were assessed (PubMed/Medline/EMBASE). Meta-analyses were conducted for comparisons. Study quality was assessed according to the Newcastle-Ottawa quality assessment scale and SYRCLE’s risk of bias tool. Results. Nineteen studies were included. Among the large animal studies, lower levels of lactate dehydrogenase (SMD -3.16, 95% CI -5.14 to -1.18), alanine transferase (SMD -2.46, 95% CI -4.03 to -0.90), and hyaluronic acid (SMD -2.48, 95% CI -4.21 to -0.74) were observed in SNMP-preserved compared to CS-preserved livers. NMP-preserved livers showing lower level of hyaluronic acid (SMD -3.97, 95% CI -5.46 to -2.47) compared to CS-preserved livers. Biliary complications (RR 0.45, 95% CI 0.28 to 0.73) and early graft dysfunction (RR 0.56, 95% CI 0.34 to 0.92) also significantly reduced with HMP preservation in human studies. No evidence of publication bias was found. Conclusions. MP preservation could improve short-term outcomes after transplantation compared to CS preservation. Additional randomized controlled trials (RCTs) are needed to develop clinical applications of MP preservation.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Publishing Corporation</pub><pmid>30255101</pmid><doi>10.1155/2018/9180757</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0001-6053-8417</orcidid><orcidid>https://orcid.org/0000-0003-3525-0133</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Alanine Analysis Animals Bias Clinical trials Cold storage Cryopreservation Hepatology Humans Hyaluronic acid L-Lactate dehydrogenase Laboratory animals Lactate dehydrogenase Lactic acid Liver Liver - enzymology Liver Transplantation Meta-analysis Organ Preservation Perfusion Political aspects Preservation Quality assessment Quality control Review Rodents Studies Swine Systematic review Therapeutic applications Transplantation Transplants & implants |
| title | Optimizing Livers for Transplantation Using Machine Perfusion versus Cold Storage in Large Animal Studies and Human Studies: A Systematic Review and Meta-Analysis |
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