The Role of Normothermic Machine Perfusion in Extended Criteria Donor Grafts: A New Direction in Liver Graft Assessment and Preservation

Despite improvements in short-term and long-term outcomes of liver transplant patients, the discrepancy between the number of available livers and transplant candidates continues to increase. The use of expanded criteria donors is one strategy that can be used to address donor shortages. In recent y...

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Published inLivers Vol. 3; no. 4; pp. 709 - 726
Main Authors Malkawi, Dima, Savsani, Kush, Alfonso, Anjelica, Lee, Seung Duk, James, Nicholas, Sarkar, Devanand, Imai, Daisuke, Khan, Aamir, Sharma, Amit, Kumaran, Vinay, Bruno, David, Cotterell, Adrian, Levy, Marlon F.
Format Journal Article
LanguageEnglish
Published Kansas City MDPI AG 01.12.2023
Subjects
Automation
Blood & organ donations
Clinical trials
Cold storage
extended criteria donor
Ischemia
liver transplant
Liver transplants
machine perfusion
Metabolism
normothermic
Physiology
Veins & arteries
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Summary:Despite improvements in short-term and long-term outcomes of liver transplant patients, the discrepancy between the number of available livers and transplant candidates continues to increase. The use of expanded criteria donors is one strategy that can be used to address donor shortages. In recent years, preservation strategies such as normothermic machine perfusion (NMP) have been explored to improve the preservation of organs and test their viability before transplantation. We reviewed the recent literature and trials assessing the use of NMP in the setting of liver transplantation. Multiple feasibility trials have demonstrated the clinical prospect of NMP and proved its numerous advantages compared to conventional static cold storage. These advantages include preservation and viability assessment of high-risk donor allografts and grafts that would have otherwise been discarded. This review aims to address the topic of liver NMP in the setting of current and future applications in the setting of extended criteria donor grafts.
ISSN:2673-4389
2673-4389
DOI:10.3390/livers3040046