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Selected Publication:

Suppan, H.
Machine Perfusion in Organ Transplantation: A Comprehensive Review
Humanmedizin; [ Diplomarbeit ] Medical University of Graz; 2019. pp.

 

Authors Med Uni Graz:
Advisor:
Leber Bettina
Stiegler Philipp
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Abstract:
Background: The worldwide lack of suitable donor organs for transplantation is increasingly becoming a problem. In order to be able to counteract this, donor organs of poorer quality or donors after cardiovascular arrest (instead of the usual brain death donors) are increasingly used. Therefore, it is an urgent goal to increase the pool of donor organs. Traditionally, organs are removed from the donor, flushed, and transported to the recipient hospital on ice. This method, which has been used for a long time, increases the risk of injuries and damage during rewarming, especially for organs of inferior quality, as well as for early organ failure after implantation. With the different methods of the machine perfusion such damages can possibly be stopped. The aim of this review study was to compare the perfusion machines of three different manufacturers with regard to the outcome of different organs and to identify possible advantages and disadvantages. This was done primarily with regard to the liver. Methods: After a literature search, the selected studies (from the years 2014 to 2018) were analysed and - as far as possible - compared with each other. Results: With regard to the liver, the results of the two types of machine used showed hardly any differences despite different types of perfusion (hypothermic-normothermic; different pump systems). The possibility of sufficiently examining and evaluating an organ during machine perfusion was seen positively by numerous authors. With the machines that are transportable, the possible longer preservation time proves to be an advantage, as longer transport distances are also possible. Some of the authors already see the methods of machine perfusion as safe and usable and ready for broad clinical use. Nevertheless, the majority of the authors propose further studies to deepen and extend the knowledge already gained. Conclusion: Machine perfusion largely meets the expectations placed in it. The findings show that in the future more organs of poorer quality could be used with this technique. Further future developments, such as the possible addition of growth factors, stem cells and drugs during machine perfusion, would also expand the possibilities of transplantation.

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