Abstract Background The pressure on liver-transplant programmes has expanded the usage of extended-criteria allografts. Machine perfusion may be better than conventional static cold storage (SCS) in alleviating ischaemia–reperfusion injury in this setting. Recipient outcomes with hypothermic or normothermic machine perfusion were assessed against SCS here. Methods A search in MEDLINE, EMBASE and Scopus was conducted in February 2021. Primary studies investigating ex vivo machine perfusion were assessed for the following outcomes: morbidity, ICU and hospital stay, graft and patient survival rates and relative costs. Meta-analysis was performed to obtain pooled summary measures. Results Thirty-four articles involving 1742 patients were included, of which 20 were used for quantitative synthesis. Odds ratios favoured hypothermic machine perfusion (over SCS) with less early allograft dysfunction, ischaemic cholangiopathy, non-anastomotic strictures and graft loss. Hypothermic machine perfusion was associated with a shorter hospital stay and normothermic machine perfusion with reduced graft injury. Two randomized clinical trials found normothermic machine perfusion reduced major complication risks. Conclusion Machine perfusion assists some outcomes with potential cost savings.

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离体机器灌注后的肝移植结果：荟萃分析

摘要 背景肝移植计划的压力扩大了扩展标准同种异体移植的使用。在这种情况下，机器灌注可能比传统的静态冷藏（SCS）更好地减轻缺血再灌注损伤。此处根据 SCS 评估低温或常温机器灌注的受者结局。 方法2021 年 2 月在 MEDLINE、EMBASE 和 Scopus 中进行了检索。调查离体机器灌注的初步研究评估了以下结果：发病率、ICU 和住院时间、移植物和患者存活率以及相对成本。进行荟萃分析以获得汇总的汇总指标。 结果纳入 34 篇文章，涉及 1742 名患者，其中 20 篇用于定量合成。优势比有利于低温机器灌注（相对于 SCS），早期同种异体移植功能障碍、缺血性胆管病、非吻合口狭窄和移植物丢失较少。低温机器灌注可缩短住院时间，常温机器灌注可减少移植物损伤。两项随机临床试验发现常温机器灌注可降低主要并发症风险。 结论机器灌注有助于某些结果并可能节省成本。