Work

Machine Perfusion Ameliorates Nonanastomotic Strictures After Liver Transplantation: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: INTRODUCTION: Machine perfusion (MP) technology may reduce the incidence of biliary complications (BCs) by reducing ischemia-reperfusion injury. This meta-analysis aimed to compare the effects of MP and static cold storage (SCS) on the incidence of BCs, nonanastomotic stricture (NAS), and anastomotic stricture (AS) after liver transplantation. METHODS: Randomized controlled trials (RCTs) comparing the effects of MP versus SCS on BCs, NAS, or AS after liver transplantation were included for the systematic review in October 2024. Random-effects models were used to perform pooled analyses to calculate risk ratios (RRs) with 95% confidence intervals (CIs). RESULTS: A total of 9 RCTs including 6 hypothermic oxygenate perfusion (HOPE) and 3 normothermic MP (NMP) were eligible for inclusion. Compared with SCS, MP technology seemed to reduce the incidence of BCs (HOPE: RR 0.77, 95% CI 0.62-0.97, P = 0.03; NMP: RR 0.67, 95% CI 0.44-1.00, P = 0.05). In addition, MP technology could explicitly reduce NAS incidence (HOPE: RR 0.40, 95% CI 0.19-0.84, P = 0.01; NMP: RR 0.39, 95% CI 0.19-0.83, P = 0.01). However, MP technology was likely unable to reduce the incidence of AS (HOPE: RR 0.89, 95% CI 0.63-1.26, P = 0.51; NMP: RR 0.99, 95% CI 0.53-1.85, P = 0.99). DISCUSSION: This meta-analysis confirmed that MP technology could reduce the incidence of NAS, which might further lead to a reduction in the incidence of BCs. However, it did not seem to improve AS incidence.

Source: Clinical and Translational Gastroenterology

DOI: 10.14309/ctg.0000000000000978