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Is single portal vein perfusion the best approach for machine preservation of liver grafts
We have read with great interest the article by Schlegel et al., describing a single portal vein approach for hypothermic oxygenated machine perfusion (HOPE) of donation after circulatory death (DCD) liver grafts. It is unquestionable that single portal vein perfusion adds simplicity to liver machine perfusion and may provide protection. However, the main question that needs to be addressed is whether this is the best perfusion technique.
Thrombolytic protocol minimizes ischemic-type biliary complications in liver transplantation from donation after circulatory death donors
With interest, we have read the article by Seal et al. recently published in Liver Transplantation. The authors proposed that injection of tissue plasminogen activator, a potent thrombolytic agent, into the hepatic artery of donation after circulatory death (DCD) donor livers before transplantation reduces the incidence of biliary strictures after liver transplantation. We would like to challenge the basis for this potentially harmful therapy and wonder whether there is any evidence for the presence of thrombi in the biliary microcirculation of livers from DCD donors.