Reducing cold ischemia time by donor liver “back-table” preparation under continuous oxygenated machine perfusion of the portal vein

Veerle A. Lantinga, Carlijn I. Buis, Robert J. Porte, Vincent E. de Meijer, Otto B. van Leeuwen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)
16 Downloads (Pure)


Introduction: Cold ischemia time is a well-known risk factor for the development of non-anastomotic biliary strictures (NAS) after liver transplantation. End-ischemic hypothermic oxygenated machine perfusion (HOPE) of DCD liver grafts reduces the incidence of NAS, and has the potential to reduce cold ischemia times. We hypothesized that if a part of the back-table procedure could be performed under continuous HOPE, cold ischemia times would be reduced. Methods: In this prospective observational cohort study, all nationwide declined livers that underwent DHOPE-NMP between July 1st 2021 and January 1st 2022 were included. The back-table of ten consecutive high-risk donor livers was performed with ongoing HOPE. Sixty DHOPE-NMP procedures (August 1st 2017–July 1st 2021) with a conventional back-table procedure functioned as a control group. Results: Compared to the control group, this technique led to a decrease in non-oxygenated back-table time from median 74 min (IQR 58–92 min) to median 25 min (IQR 21–31 min), p <.01. Median total cold preservation times were reduced from 279 min (IQR 254–297) to 214 min (IQR 132–254), p <.01. Conclusion: Cold ischemia time of liver grafts can be successfully reduced by over one hour by using portal vein only HOPE during back-table preparation.

Original languageEnglish
Article numbere14762
JournalClinical Transplantation
Issue number8
Publication statusPublished - Aug 2022
Externally publishedYes

Bibliographical note

Funding Information:
Funding of the local machine perfusion program was obtained by the Netherlands Ministry of Health, Welfare and Sport.

Publisher Copyright:
© 2022 The Authors. Clinical Transplantation published by John Wiley & Sons Ltd.


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