Normothermic Machine Perfusion in pediatric liver transplantation: A survey of attitudes and barriers.

Autor: Kadakia Y; University of Texas Southwestern Medical Center, Dallas, Texas, USA., MacConmara M; Department of Surgery, Division of Surgical Transplantation, University of Texas Southwestern Medical Center, Dallas, Texas, USA.; Division of Pediatric Transplantation, Children's Medical Center, Dallas, Texas, USA.; TransMedics Inc., Andover, Massachusetts, USA., Patel MS; Department of Surgery, Division of Surgical Transplantation, University of Texas Southwestern Medical Center, Dallas, Texas, USA.; Division of Pediatric Transplantation, Children's Medical Center, Dallas, Texas, USA., Shah JA; Department of Surgery, Division of Surgical Transplantation, University of Texas Southwestern Medical Center, Dallas, Texas, USA.; Division of Pediatric Transplantation, Children's Medical Center, Dallas, Texas, USA., de Gregorio Muniz L; Department of Surgery, Division of Surgical Transplantation, University of Texas Southwestern Medical Center, Dallas, Texas, USA.; Division of Pediatric Transplantation, Children's Medical Center, Dallas, Texas, USA., Desai DM; Department of Surgery, Division of Surgical Transplantation, University of Texas Southwestern Medical Center, Dallas, Texas, USA.; Division of Pediatric Transplantation, Children's Medical Center, Dallas, Texas, USA., Hanish S; Department of Surgery, Division of Surgical Transplantation, University of Texas Southwestern Medical Center, Dallas, Texas, USA.; Division of Pediatric Transplantation, Children's Medical Center, Dallas, Texas, USA., Vagefi PA; Department of Surgery, Division of Surgical Transplantation, University of Texas Southwestern Medical Center, Dallas, Texas, USA.; Division of Pediatric Transplantation, Children's Medical Center, Dallas, Texas, USA., Hwang CS; Department of Surgery, Division of Surgical Transplantation, University of Texas Southwestern Medical Center, Dallas, Texas, USA.; Division of Pediatric Transplantation, Children's Medical Center, Dallas, Texas, USA.
Jazyk: angličtina
Zdroj: Pediatric transplantation [Pediatr Transplant] 2022 Aug; Vol. 26 (5), pp. e14282. Date of Electronic Publication: 2022 Apr 20.
DOI: 10.1111/petr.14282
Abstrakt: Background: NMP provides a superior strategy for the assessment and preservation of marginal donor livers and has demonstrated increased utilization and enhances organ quality when used in adult liver transplantation. We aimed to evaluate the interest of incorporating the use of NMP in pediatric liver transplantation.
Methods: An anonymous online survey was distributed to pediatric transplant surgeons and hepatologists across the United States. Respondent demographic information, attitudes toward NMP in pediatric liver transplantation, and barriers to utilization were examined.
Results: Thirty-two providers (18 transplant surgeons and 14 hepatologists) completed the survey, yielding a response rate of 64%. Half (50%) of respondents indicated prior exposure to NMP. Overall, 96% of respondents believed there was benefit to using NMP in pediatric liver transplantation. DCD (68%) and post-cross-clamp (75%) grafts were the greatest opportunity for NMP use. A role in splitting livers ex vivo (71%) was also seen as a potential major opportunity. Cost was perceived as a barrier to implementation (36%), followed by institutional factors (32%). Cost tolerance was significantly greater in respondents residing in OPTN regions with greater than median wait times (63% vs. 11% in OPTN regions with greater vs. shorter wait times, p = .010).
Conclusions: There is significant interest within the pediatric liver transplant community for NMP to expand the donor pool. Interest appears particularly strong in regions where wait times for suitable pediatric donors are prolonged.
(© 2022 Wiley Periodicals LLC.)
Databáze: MEDLINE
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