TY - JOUR
T1 - The Risk of Microbial Transmission in Recipients of Donor Livers That Underwent Hypothermic or Normothermic Machine Perfusion
AU - Endo, Chikako
AU - Lascaris, Bianca
AU - Brüggenwirth, Isabel M A
AU - Roggeveld, Jan
AU - Blokzijl, Hans
AU - de Meijer, Vincent E
AU - Doting, M H Edwina
AU - Porte, Robert J
N1 - Publisher Copyright:
© 2024 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.
PY - 2024/7
Y1 - 2024/7
N2 - BACKGROUND: Ex situ machine perfusion is increasingly used to preserve and assess donor livers before transplantation. Compared with traditional static cold storage (SCS), machine perfusion exposes livers to an additional risk of microbial contamination. However, information on the risk of microbial transmission during machine perfusion is lacking.METHODS: All livers that underwent either hypothermic oxygenated machine perfusion (HOPE) or normothermic machine perfusion (NMP) in our center between September 2021 and September 2023, and during which samples were taken from SCS fluid and/or machine perfusion solution for microbiological examination, were included in this retrospective, observational clinical study. Microbial transmission was examined from SCS fluid to machine perfusion solution fluid and, subsequently, to recipients of these livers.RESULTS: A total of 90 cases of liver machine perfusion were included: 59 HOPE and 31 NMP. SCS preservation fluid cultures before HOPE or NMP were positive for at least 1 microorganism in 52% of the cases. After HOPE, there were no cases of positive machine perfusion fluid or evidence of microbial transmission to the recipients. After NMP, in 1 (3%) patient
Escherichia coli was grown from abdominal drain fluid, the same bacterial strain that was also grown from the SCS preservation fluid before NMP. This
E coli was resistant to the antibiotics that are routinely added to the NMP perfusion fluid.
CONCLUSIONS: The risk of microbial transmission after machine perfusion is very low but not absent. We recommend routine sampling of machine perfusion fluid at the end of the procedure for microbiological analysis.
AB - BACKGROUND: Ex situ machine perfusion is increasingly used to preserve and assess donor livers before transplantation. Compared with traditional static cold storage (SCS), machine perfusion exposes livers to an additional risk of microbial contamination. However, information on the risk of microbial transmission during machine perfusion is lacking.METHODS: All livers that underwent either hypothermic oxygenated machine perfusion (HOPE) or normothermic machine perfusion (NMP) in our center between September 2021 and September 2023, and during which samples were taken from SCS fluid and/or machine perfusion solution for microbiological examination, were included in this retrospective, observational clinical study. Microbial transmission was examined from SCS fluid to machine perfusion solution fluid and, subsequently, to recipients of these livers.RESULTS: A total of 90 cases of liver machine perfusion were included: 59 HOPE and 31 NMP. SCS preservation fluid cultures before HOPE or NMP were positive for at least 1 microorganism in 52% of the cases. After HOPE, there were no cases of positive machine perfusion fluid or evidence of microbial transmission to the recipients. After NMP, in 1 (3%) patient
Escherichia coli was grown from abdominal drain fluid, the same bacterial strain that was also grown from the SCS preservation fluid before NMP. This
E coli was resistant to the antibiotics that are routinely added to the NMP perfusion fluid.
CONCLUSIONS: The risk of microbial transmission after machine perfusion is very low but not absent. We recommend routine sampling of machine perfusion fluid at the end of the procedure for microbiological analysis.
UR - http://www.scopus.com/inward/record.url?scp=85200912083&partnerID=8YFLogxK
U2 - 10.1097/TXD.0000000000001664
DO - 10.1097/TXD.0000000000001664
M3 - Article
C2 - 38953041
SN - 2373-8731
VL - 10
JO - Transplantation direct
JF - Transplantation direct
IS - 7
M1 - e1664
ER -