Temporary portocaval shunt provides superior intraoperative hemodynamics and reduces blood loss and duration of surgery in live donor liver transplantation. A randomized controlled trial.

Kang M, Kim S, Choi JY, Kim KS, Jung YK, Park B et al. 

Br J Surg 2024; 111: znae102.

This meta-analysis of machine perfusion included 19 RCTs. The risk of delayed graft function was lowest after hypothermic machine perfusion: relative risk 0.77, 95 per cent confidence interval 0.69 to 0.86). Partial hypothermic perfusion was not effective.

Comment: Soon to be the standard of care?

Bang JY, Lakhtakia S, Thakkar S, Buxbaum JL, Waxman I, Sutton B et al, on behalf of the United States Pancreatic Disease Study Group.

Lancet Gastrohepatol 2024; 9: 22-33.

Seventy patients were included. Upfront necrosectomy resulted in fewer reinterventions (median 1 vs 2, P=0.003), but did not reduce mortality (none versus 2, respectively, P=0.22), or adverse events.

Comment: Smallish study, but indications of advantage for earlier intervention, rather than wait and see.

Labori KJ, Bratlie SO, Andersson B, Angelsen J-H, Biorserud C, Bjornsson B et al, for the Nordic Pancreatic Cancer Trial-1 study group.

Lancet Gastrohepatol 2024; 9: 205-217.

Survival after 18 months was not improved after neoadjuvant chemotherapy (73 per cent, versus 60 per cent in controls, P=0.050) in this study that included 140 patients.

Comment: Negative result here, but more data for a larger meta-analysis.