A Systematic Review and Meta-Analysis of Machine Perfusion vs. Static Cold Storage of Liver Allografts on Liver Transplantation Outcomes: The Future Direction of Graft Preservation
Junjun Jia, Yu Nie, Jianhui Li, Haiyang Xie, Lin Zhou, Jun Yu, Shusen Zheng
Abstract
Background: Machine perfusion (MP) and static cold storage (CS) are two prevalent methods for liver allograft preservation. However, the preferred method remains controversial. Aim：To conducted a meta-analysis on the impact of MP preservation on liver transplant outcome. Methods: The Pubmed, EMBASE and Cochrane Library databases were systematically searched to identify relevant trials comparing the efficacy of MP versus CS. Odds ratios (OR) and fixed effects models were calculated to compare the pooled data. Results: 10 prospective cohort studies and 2 randomized controlled trials were included(MP livers versus CS livers = 315 : 489). Machine perfusion demonstrated superior outcomes in post transplantation AST levels compared to CS (P0.05). Conclusions: MP is superior to CS on improving short-term outcomes for human LT, with a less clear effect in the longer-term. HMP but not NMP conducted significantly protective effects on EAD and biliary complications. Further RCTs are warranted to confirm MP’s superiority and applications.