Restoring Life to the Liver: Normothermic Regional Perfusion in Modern Transplantation

Normothermic Regional Perfusion in Controlled Donation After Circulatory Death: Growing Evidence for Liver Transplantation

Normothermic regional perfusion (NRP) is reshaping controlled donation after circulatory death (cDCD) liver transplantation. By restoring oxygenated blood flow after death declaration, NRP reduces ischemia-reperfusion injury, lowers rates of early allograft dysfunction and biliary complications, and delivers graft and patient survival comparable to donation after brain death. This review synthesizes expanding global evidence supporting NRP as a new standard.

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Incidence and Risk Factors of Limb Ischaemia

Incidence and Risk Factors of Limb Ischaemia in Adult Patients Receiving Veno-Arterial Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis

Limb ischaemia is a serious complication of veno-arterial extracorporeal membrane oxygenation (V-A ECMO). This systematic review and meta-analysis of 17 studies involving 2,812 adults found a pooled limb ischaemia incidence of 16.9%. Peripheral arterial disease, unsuccessful percutaneous cannulation, and shorter patient height were significant risk factors, underscoring the need for early risk identification and preventive strategies in ECMO care.

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Selective Ex Vivo Lung Perfusion in Donation After Circulatory Death Transplantation

Ex Vivo Lung Perfusion in Donation After Circulatory Death Lung Transplantation: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis evaluated whether ex vivo lung perfusion (EVLP) improves outcomes in donation after circulatory death (DCD) lung transplantation. Across five observational studies including 654 patients, EVLP showed no significant differences in grade 3 primary graft dysfunction, ICU or hospital length of stay, short-term survival, pneumonia, or acute rejection compared with direct transplantation. Findings support selective rather than routine EVLP use.

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Determination of Insensible Water Loss and Sodium Accumulation Behavior from the Medtronic Nautilus ECMO Oxygenator: An In Vitro Study

Determination of Insensible Water Loss and Sodium Accumulation Behavior from the Medtronic Nautilus ECMO Oxygenator: An In Vitro Study

This in vitro study examined insensible water loss and sodium accumulation in the Medtronic Nautilus ECMO oxygenator. Using varying sweep gas rates over 24 hours, researchers found a strong linear relationship between sweep gas flow and fluid loss. The rate was approximately 72.5 mL/day per 1 L/min sweep gas. Sodium accumulation was observed but not statistically confirmed due to sample size. These findings are critical for managing fluid balance and hypernatremia risk in ECMO patients.

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Impact of Prolonged Cardiopulmonary Bypass

Impact of Prolonged Cardiopulmonary Bypass on Gastrointestinal Complications in Cardiac Surgery: A Retrospective Cohort Study

This retrospective cohort study assessed the effect of prolonged cardiopulmonary bypass (CPB ≥ 120 minutes) on gastrointestinal complications (GICs) after cardiac surgery. Analyzing 1,444 patients and using propensity score matching, the study found a significantly higher rate of GICs in the prolonged CPB group. Key risk factors included hypertension, lower left ventricular ejection fraction (LVEF), and undergoing aortic surgery.

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Near-Infrared Spectroscopy to Monitor Cerebral and Renal Oxygen Saturation During Cardiopulmonary Bypass Surgery

Near-Infrared Spectroscopy to Monitor Cerebral and Renal Oxygen Saturation During Cardiopulmonary Bypass Surgery for Paediatric Congenital Heart Disease: Study Protocol for a Prospective Observational Cohort Trial

This BMJ Open study outlines a prospective cohort trial evaluating near-infrared spectroscopy (NIRS) to monitor cerebral and renal oxygen saturation during pediatric cardiopulmonary bypass surgery. It aims to link intraoperative oxygenation levels with postoperative brain and kidney injuries, assessing outcomes with biomarkers and quality-of-life metrics. Findings could improve organ injury prediction and perioperative care in congenital heart disease surgeries.

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CytoSorb Filter During Kidney Normothermic

Protocol for a Single-Centre Randomised Pilot Study to Assess the Safety and Feasibility of Adding a CytoSorb Filter During Kidney Normothermic Machine Perfusion to Remove Inflammatory and Immune Mediators Prior to Kidney Transplantation

This pilot study assesses the safety and feasibility of using a CytoSorb filter during kidney normothermic machine perfusion (NMP) before transplantation. The goal is to reduce inflammation-related damage by filtering immune mediators. Twenty patients will be randomized to receive kidneys preserved with or without the filter. Outcomes include immune gene expression, delayed graft function, and kidney performance at intervals post-transplant.

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Comparison of Del Nido and Histidine-Tryptophan-Ketoglutarate

Comparison of Del Nido and Histidine-Tryptophan-Ketoglutarate Cardioplegia Solutions: An Animal Study With Prolonged Ischaemia

This study compares Del Nido (DN) and Bretschneider histidine-tryptophan-ketoglutarate (HTK) cardioplegia solutions in a porcine model of prolonged ischaemia. DN demonstrated superior left ventricular function, spontaneous return to sinus rhythm, and less haemodilution and endothelial dysfunction compared to HTK. Histological and biochemical markers of injury, stress, and apoptosis showed no significant differences, suggesting DN offers enhanced myocardial protection during cardiac surgery.

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Innominate Artery Graft Cannulation

Innominate Artery Graft Cannulation for Selective Antegrade Cerebral Perfusion in Aortic Surgery: Clinical Findings and Feasibility

This retrospective study evaluates the safety and efficacy of innominate artery (IA) graft cannulation for selective antegrade cerebral perfusion (SACP) in aortic surgery. Analyzing 196 patients, including those with Type A acute aortic dissection and Marfan syndrome, the results showed low rates of stroke (2.04%), mortality (3.06%), and acute renal failure (3.06%). IA graft cannulation emerged as a reliable and efficient technique for cerebral protection during complex aortic procedures.

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Impact of Extracorporeal Life Support on Outcome in Patients with Idiopathic Pulmonary Arterial Hypertension Awaiting Lung Transplantation

Impact of Extracorporeal Life Support on Outcome in Patients with Idiopathic Pulmonary Arterial Hypertension Awaiting Lung Transplantation

This study evaluates the impact of extracorporeal life support (ECLS) as a bridge to lung transplantation (BTT) for patients with idiopathic pulmonary arterial hypertension (iPAH). A comparison between two cohorts (1997–2005 and 2006–2010) shows that ECLS significantly reduced waiting list mortality (from 22% to 0%) while slightly increasing ICU stay. The findings suggest that aggressive ECLS management can improve survival rates for iPAH patients awaiting lung transplants.

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