Successful Ex Situ Reduction During Hypothermic Oxygenated Machine Perfusion in a Severely Steatotic Graft From a Donor After Brain Death: An Anecdote?

Marginal liver grafts, such as those from cardiac death donors and donors with steatotic organs, are highly vulnerable to ischemia-reperfusion injury. In addition, ex situ graft alteration, either by reduction or splitting, will prolong the static cold storage time and amplify the ischemia-reperfusion injury. Hypothermic oxygenated machine perfusion has the potential to end the oxygen deprivation during preservation and accordingly improve outcomes in some marginal grafts that have been traditionally discarded.