Yashavanth Kumar MS, DNB, Flw HPB/LT(King's/Leeds)

Hepatobiliary and Liver Transplant Surgeon,
Abdomen Organ Retrieval surgeon (Special Interest in Machine perfusion),
Transmedics, MA

[Yashavanth Kumar MS, DNB, Flw HPB/LT(King's/Leeds) @yeshikims]

My Tryst with machines 😃

[American Journal of Transplantation @amjtransplant]

Available in our August issue: "Normothermic machine perfusion of pediatric liver allografts: A single-center case series," by Huang et al
https://t.co/QjhfTXz20j
#LiverTransplantation #PediatricTransplantation #MachinePerfusion #OrganPreservation

[Yashavanth Kumar MS, DNB, Flw HPB/LT(King's/Leeds) @yeshikims]

#stopviolence #healthcareheroes #healthcareviolence #medicos
https://t.co/WZey17xBor

[Yashavanth Kumar MS, DNB, Flw HPB/LT(King's/Leeds) @yeshikims]

https://t.co/Woa5ZxOqRH

Towards making it a standard of care instead of just an option. Ex situ Machine perfusion of Deceased donor Livers.

[Yashavanth Kumar MS, DNB, Flw HPB/LT(King's/Leeds) @yeshikims]

@theliverdoc Happy Birthday Abby. Have a wonderful year 🎁

[Liver Transplantation Journal (LTxJournal) @LTxJournal]

Can portable NMP improve liver graft survival? In 1,723 LTs, DCD grafts preserved with pNMP had better graft survival than SCS. pNMP enabled longer preservation, while hepatic artery flow on pump predicted graft survival.

https://t.co/spyY4CjwV4

[Yashavanth Kumar MS, DNB, Flw HPB/LT(King's/Leeds) @yeshikims]

There's now enough evidence to suggest "Doing DCD liver transplant without dynamic preservation is same as driving a car without airbags or seatbelts" Risky!!! #NMP #Liver #transplant #NRP #HMP

[Liver Transplantation Journal (LTxJournal) @LTxJournal]

In DCD liver transplantation, normothermic machine perfusion was independently associated with lower odds of AKI, severe AKI (stage 2/3), and renal replacement therapy compared with static cold storage.
#LiverTransplantation #LiverTwitter #MachinePerfusion
https://t.co/msfHAUzk1C

[UtahTransplantDoctor @JeffCampsenMD]

Impressive new data out of Baylor on pediatric liver NMP.
14 small donors (<35 kg), including 9 DCD, placed on adapted normothermic machine perfusion. 12 met viability criteria and were successfully transplanted — zero primary nonfunction or patient deaths in early follow-up.
This is real innovation. NMP is starting to expand the pediatric donor pool the same way it transformed adult liver transplantation. Huge potential for kids who need these organs most.
🔗 https://t.co/pKQz5NXsRk

[Yashavanth Kumar MS, DNB, Flw HPB/LT(King's/Leeds) @yeshikims]

Variant Liver Arterial anatomy is not a limitation to put the liver on NMP: This expands the indication for pumping the Liver with complex anatomy.

Overcoming hepatic artery variations: Arterial... : Liver Transplantation https://t.co/VPlfBD32iR

[Yashavanth Kumar MS, DNB, Flw HPB/LT(King's/Leeds) @yeshikims]

Normothermic machine perfusion of pediatric liver allografts: A single-center case series - American Journal of Transplantation https://t.co/Sz1WZk3jd7

[Yashavanth Kumar MS, DNB, Flw HPB/LT(King's/Leeds) @yeshikims]

It is the only way forward to increase utilisation of donated organs. Hope other countries follow the path.

https://t.co/DlQvg81TOb

[M Velia Antonini @FOAMecmo]

Integrating #CRRT into ex-situ normothermic liver machine perfusion? To
⚖️ support solute clearance vs accumuling metabolic waste, electrolyte imbalances, inflammatory mediators
💦 reduce risk of tissue edema
maintaining stable perfusion dynamics and improving graft function during extended NMP periods. Here, reproducible & safe method to connect CVVHDF into NMP independently from main perfusion circuit + how to prime, monitor & manage.
🖇️ https://t.co/DludHt1lLE

[Yashavanth Kumar MS, DNB, Flw HPB/LT(King's/Leeds) @yeshikims]

Liver Re-transplantations are technically challenging procedure and time consuming. Having a rejuvenated graft chilling on NMP, takes out a lot of burden. Reducing morbidity and mortality significantly.
https://t.co/6j69GH2BBo

[Yashavanth Kumar MS, DNB, Flw HPB/LT(King's/Leeds) @yeshikims]

Ex situ Normothermic Machine Perfusion Reduces Post-reperfusion Syndrome and Improves Patient and Graft Survival following Liver Transplant using Macrosteatotic Liver Grafts - American Journal of Transplantation https://t.co/ktezGjXz47

[Yashavanth Kumar MS, DNB, Flw HPB/LT(King's/Leeds) @yeshikims]

This paper explains how Machine Perfusion is positively contributing towards increased liver utilization despite going for marginal organs. #NMP #machineperfusion. https://t.co/Yn9LZuDmiC

[UCLA Radiology @RadiologyUcla]

In a study of &gt;7,900 patients with HCC or CCA, normothermic machine perfusion was linked to higher transplant probability &amp; lower dropout risk for HCC. Patients at high-volume NMP centers also had greater access. More from @RadiologyUcla: https://t.co/ZmkYS3u54D

[Yashavanth Kumar MS, DNB, Flw HPB/LT(King's/Leeds) @yeshikims]

@theliverdoc Congratulations Abby

[Yashavanth Kumar MS, DNB, Flw HPB/LT(King's/Leeds) @yeshikims]

Donor site initiated NMP(OCS Transmedics) has the best outcome in terms of Ischemic biliary complications, less EAD, overall better post op outcomes. @JAMASurgery @amjtransplant https://t.co/rhyF7alGtu

[Yashavanth Kumar MS, DNB, Flw HPB/LT(King's/Leeds) @yeshikims]

This suggests why back to base is not a good model. Within DCD sub cohort Biliary complications to the tune of 18%(AS+NAS) using HOPE(Bridge to Life)and 50%(AS 21% + NAS 29%) using NMP(Organox).
https://t.co/2f0HDAxRnZ

[Raphael Meier MD-PhD @meier_raphael]

Machine perfusion is transforming access to donor livers. In our @TransplantJrnl Letter, we ask: complement or competition with living donation? We find them complementary—LDLT remains vital, especially for peds &amp; oncology. Policy must balance innovation, equity &amp; sustainability