In House Oxygen Persufflation of Cold Stored Livers Versus Simple Cold Storage in Extended Criteria Liver Grafts: 5-year Results of a Randomized Controlled Clinical Trial

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Both study groups were comparable except for a longer ICU stay (4 vs. 3 days) of the donors and a higher recipient age (57 vs. 52 years) in the O2-group. S-TNF-α and TNF gene expression in liver tissue 1h after reperfusion was reduced in the O2 group (p<0.05). Median peak-AST values did not differ between the groups (O2: 580 U/l, control: 699 U/l). 2 patients (1.7%) were re-transplanted for PNF/hepatic artery thrombosis. Five year patient- and graft survival was similar (O2 vs. control: 74% vs. 66% and 89% vs. 82%, p=n.s.). On multivariate Analysis 5 year patient survival was significantly improved in livers within macrosteatosis, donor age > 70years and when cold ischemia time was prolonged when O2 persufflation was applied.


Oxygen persufflation can be considered as a safe and easy alternative to simple cold storage or machine perfusion in predamaged livers.

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