Transforming Transplant Oversight: Enhancing Combined Cardiothoracic Surgery and Liver Transplantation With Normothermic Machine Perfusion
Background. Simultaneous cardiothoracic surgery and liver transplantation (LT) is a high-risk procedure associated with high mortality and morbidity rates. The use of normothermic machine perfusion (NMP) allows graft quality enhancement, assessment of liver viability, and logistics optimization, exp...
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| Language: | English |
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Wolters Kluwer
2025-06-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001810 |
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| author | Beatrice Cazzaniga, MD Khaled Ali, MD Jiro Kusakabe, MD, PhD, MPH Qiang Liu, MD, PhD, MSc Munkhbold Tuul, MD, PhD Yuki Miyazaki, MD Esteban Calderon, MD Kumaran Shanmugarajah, MD, PhD Glenn Wakam, MD Chase J. Wehrle, MD Mingyi Zhang, MD Alejandro Pita, MD Masato Fujiki, MD, PhD Jaekeun Kim, MD Andrea Schlegel, MD, MBA Bijan Eghtesad, MD Choon H. David Kwon, MD, PhD Federico Aucejo, MD Mazhar Khalil, MD Teresa Diago-Uso, MD Michael Z.-Y. Tong, MD Shinya Unai, MD Kenneth R. McCurry, MD Maan Fares, MD Jamak Modaresi-Esfeh, MD Jacek Cywinski, MD Cristiano Quintini, MD Charles Miller, MD Koji Hashimoto, MD, PhD |
| author_facet | Beatrice Cazzaniga, MD Khaled Ali, MD Jiro Kusakabe, MD, PhD, MPH Qiang Liu, MD, PhD, MSc Munkhbold Tuul, MD, PhD Yuki Miyazaki, MD Esteban Calderon, MD Kumaran Shanmugarajah, MD, PhD Glenn Wakam, MD Chase J. Wehrle, MD Mingyi Zhang, MD Alejandro Pita, MD Masato Fujiki, MD, PhD Jaekeun Kim, MD Andrea Schlegel, MD, MBA Bijan Eghtesad, MD Choon H. David Kwon, MD, PhD Federico Aucejo, MD Mazhar Khalil, MD Teresa Diago-Uso, MD Michael Z.-Y. Tong, MD Shinya Unai, MD Kenneth R. McCurry, MD Maan Fares, MD Jamak Modaresi-Esfeh, MD Jacek Cywinski, MD Cristiano Quintini, MD Charles Miller, MD Koji Hashimoto, MD, PhD |
| author_sort | Beatrice Cazzaniga, MD |
| collection | DOAJ |
| description | Background. Simultaneous cardiothoracic surgery and liver transplantation (LT) is a high-risk procedure associated with high mortality and morbidity rates. The use of normothermic machine perfusion (NMP) allows graft quality enhancement, assessment of liver viability, and logistics optimization, expanding the donor pool and reducing organ discard rate. We share our institution’s experience with simultaneous cardiothoracic surgery and LT, using NMP for liver graft preservation and viability assessment.
Methods. Data was retrospectively collected from 14 patients who underwent simultaneous cardiothoracic surgery and LT with NMP for liver graft preservation from October 2022 to August 2023. Data was divided into 3 groups: combined heart transplant and LT, lungs transplant and LT, and nontransplant cardiothoracic surgery and LT.
Results. All liver grafts were from brain-dead donors. Median machine perfusion times were 211 min (range, 186–242 min), 222 min (range, 211–246 min), and 627 min (range, 180–1003 min) across the 3 groups, respectively. Postreperfusion syndrome occurred in 3 patients (21%), with 5 (36%) readmitted within 30 d because of complications. Biliary complications developed in 5 patients (36%), and 2 (14%) experienced acute liver rejection within 90 d postsurgery. No mortality was recorded during the median 18-mo follow-up.
Conclusions. NMP serves as a safe and valuable tool for patients in need of simultaneous cardiothoracic surgery and LT, potentially broadening the scope of eligibility for these complex procedures. |
| format | Article |
| id | doaj-art-6cf3068e2a03416b9e3e66b9b9e71698 |
| institution | OA Journals |
| issn | 2373-8731 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj-art-6cf3068e2a03416b9e3e66b9b9e716982025-08-20T02:29:12ZengWolters KluwerTransplantation Direct2373-87312025-06-01116e181010.1097/TXD.0000000000001810202506000-00008Transforming Transplant Oversight: Enhancing Combined Cardiothoracic Surgery and Liver Transplantation With Normothermic Machine PerfusionBeatrice Cazzaniga, MD0Khaled Ali, MD1Jiro Kusakabe, MD, PhD, MPH2Qiang Liu, MD, PhD, MSc3Munkhbold Tuul, MD, PhD4Yuki Miyazaki, MD5Esteban Calderon, MD6Kumaran Shanmugarajah, MD, PhD7Glenn Wakam, MD8Chase J. Wehrle, MD9Mingyi Zhang, MD10Alejandro Pita, MD11Masato Fujiki, MD, PhD12Jaekeun Kim, MD13Andrea Schlegel, MD, MBA14Bijan Eghtesad, MD15Choon H. David Kwon, MD, PhD16Federico Aucejo, MD17Mazhar Khalil, MD18Teresa Diago-Uso, MD19Michael Z.-Y. Tong, MD20Shinya Unai, MD21Kenneth R. McCurry, MD22Maan Fares, MD23Jamak Modaresi-Esfeh, MD24Jacek Cywinski, MD25Cristiano Quintini, MD26Charles Miller, MD27Koji Hashimoto, MD, PhD281 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.2 Department of Inflammation and Immunity, Lerner Research Institute, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.3 Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Emirates.4 Department of Thoracic and Cardiovascular Surgery, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH.4 Department of Thoracic and Cardiovascular Surgery, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH.4 Department of Thoracic and Cardiovascular Surgery, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH.5 Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH.6 Department of Gastroenterology, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.7 Department of General Anesthesiology, Cleveland Clinic, Cleveland, OH.3 Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Emirates.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.1 Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.Background. Simultaneous cardiothoracic surgery and liver transplantation (LT) is a high-risk procedure associated with high mortality and morbidity rates. The use of normothermic machine perfusion (NMP) allows graft quality enhancement, assessment of liver viability, and logistics optimization, expanding the donor pool and reducing organ discard rate. We share our institution’s experience with simultaneous cardiothoracic surgery and LT, using NMP for liver graft preservation and viability assessment. Methods. Data was retrospectively collected from 14 patients who underwent simultaneous cardiothoracic surgery and LT with NMP for liver graft preservation from October 2022 to August 2023. Data was divided into 3 groups: combined heart transplant and LT, lungs transplant and LT, and nontransplant cardiothoracic surgery and LT. Results. All liver grafts were from brain-dead donors. Median machine perfusion times were 211 min (range, 186–242 min), 222 min (range, 211–246 min), and 627 min (range, 180–1003 min) across the 3 groups, respectively. Postreperfusion syndrome occurred in 3 patients (21%), with 5 (36%) readmitted within 30 d because of complications. Biliary complications developed in 5 patients (36%), and 2 (14%) experienced acute liver rejection within 90 d postsurgery. No mortality was recorded during the median 18-mo follow-up. Conclusions. NMP serves as a safe and valuable tool for patients in need of simultaneous cardiothoracic surgery and LT, potentially broadening the scope of eligibility for these complex procedures.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001810 |
| spellingShingle | Beatrice Cazzaniga, MD Khaled Ali, MD Jiro Kusakabe, MD, PhD, MPH Qiang Liu, MD, PhD, MSc Munkhbold Tuul, MD, PhD Yuki Miyazaki, MD Esteban Calderon, MD Kumaran Shanmugarajah, MD, PhD Glenn Wakam, MD Chase J. Wehrle, MD Mingyi Zhang, MD Alejandro Pita, MD Masato Fujiki, MD, PhD Jaekeun Kim, MD Andrea Schlegel, MD, MBA Bijan Eghtesad, MD Choon H. David Kwon, MD, PhD Federico Aucejo, MD Mazhar Khalil, MD Teresa Diago-Uso, MD Michael Z.-Y. Tong, MD Shinya Unai, MD Kenneth R. McCurry, MD Maan Fares, MD Jamak Modaresi-Esfeh, MD Jacek Cywinski, MD Cristiano Quintini, MD Charles Miller, MD Koji Hashimoto, MD, PhD Transforming Transplant Oversight: Enhancing Combined Cardiothoracic Surgery and Liver Transplantation With Normothermic Machine Perfusion Transplantation Direct |
| title | Transforming Transplant Oversight: Enhancing Combined Cardiothoracic Surgery and Liver Transplantation With Normothermic Machine Perfusion |
| title_full | Transforming Transplant Oversight: Enhancing Combined Cardiothoracic Surgery and Liver Transplantation With Normothermic Machine Perfusion |
| title_fullStr | Transforming Transplant Oversight: Enhancing Combined Cardiothoracic Surgery and Liver Transplantation With Normothermic Machine Perfusion |
| title_full_unstemmed | Transforming Transplant Oversight: Enhancing Combined Cardiothoracic Surgery and Liver Transplantation With Normothermic Machine Perfusion |
| title_short | Transforming Transplant Oversight: Enhancing Combined Cardiothoracic Surgery and Liver Transplantation With Normothermic Machine Perfusion |
| title_sort | transforming transplant oversight enhancing combined cardiothoracic surgery and liver transplantation with normothermic machine perfusion |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001810 |
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