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Viability Assessment During Normothermic Machine Liver Perfusion: A Literature Review.
Liver Int
February 2025
Department of Hepatobiliary and Digestive Surgery, University Hospital, Rennes 1 University, Rennes, France.
The discrepancy between donor organ availability and demand leads to a significant waiting-list dropout rate and mortality. Although quantitative tools such as the Donor Risk Index (DRI) help assess organ suitability, many potentially viable organs are still discarded due to the lack of universally accepted markers to predict post-transplant outcomes. Normothermic machine perfusion (NMP) offers a platform to assess viability before transplantation.
View Article and Find Full Text PDFBeyond the icebox: modern strategies in organ preservation for transplantation.
Clin Transplant Res
December 2024
Department of Surgery, Hanyang University College of Medicine, Seoul, Korea.
Organ transplantation, a critical treatment for end-stage organ failure, has witnessed significant advancements due to the integration of improved surgical techniques, immunosuppressive therapies, and donor-recipient matching. This review explores the progress of organ preservation, focusing on the shift from static cold storage (SCS) to advanced machine perfusion techniques such as hypothermic (HMP) and normothermic machine perfusion (NMP). Although SCS has been the standard approach, its limitations in preserving marginal organs and preventing ischemia-reperfusion injury (IRI) have led to the adoption of HMP and NMP.
View Article and Find Full Text PDFSolid organ transplantation originating from uncontrolled donation after circulatory death in Europe: a narrative review.
Scand J Trauma Resusc Emerg Med
December 2024
Emergency Department, Cliniques Universitaires Saint-Luc, Emergency Medicine, Department of Public Health and Primary Care, Faculty of Medicine, Catholic University Leuven, Brussels, Belgium.
Human organ transplantation has begun in the 1960s with donation after circulatory death. At that time this was named non heart beating donation, later donation after cardiac death and nowadays it is named donation after circulatory death. Currently, we are facing a significant shortage of transplant organs in Europe and worldwide.
View Article and Find Full Text PDFUse of Machine Perfusion in the United States Increases Organ Utilization and Improves DCD Graft Survival in Liver Transplantation.
Transplant Direct
December 2024
Comprehensive Transplant Center, Jim and Eleanor Randall Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.
Background: Adoption of machine perfusion (MP) technology has rapidly expanded in liver transplantation without real-world data on utilization and outcomes, which are critical to understand the appropriate application of MP technology.
Methods: The Organ Procurement and Transplant Network/Standard Transplant Analysis and Research database was used to identify all deceased donor livers procured with intent for transplant between October 27, 2015 (date of first recorded MP) and June 30, 2023 (n = 67 795). Liver allografts were cohorted by donation after brain death (DBD; n = 59 957) or circulatory death (DCD; n = 7873) and analyzed by static cold storage (SCS) or MP preservation method.
Long-term machine perfusion of human split livers: a new model for regenerative and translational research.
Nat Commun
November 2024
Centre for Organ Assessment Repair and Optimisation, Royal Prince Alfred Hospital, Sydney, NSW, 2050, Australia.
Recent advances in machine perfusion have revolutionised the field of transplantation by prolonging preservation, permitting evaluation of viability prior to implant and rescue of discarded organs. Long-term perfusion for days-to-weeks provides time to modify these organs prior to transplantation. By using long-term normothermic machine perfusion to facilitate liver splitting and subsequent perfusion of both partial organs, possibilities even outside the clinical arena become possible.
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