Normothermic machine perfusion-improving the supply of transplantable livers for high-risk recipients.
Abstract
The effectiveness of liver transplantation to cure numerous diseases, alleviate suffering, and improve patient survival has led to an ever increasing demand. Improvements in preoperative management, surgical technique, and postoperative care have allowed increasingly complicated and high-risk patients to be safely transplanted. As a result, many patients are safely transplanted in the modern era that would have been considered untransplantable in times gone by. Despite this, more gains are possible as the science behind transplantation is increasingly understood. Normothermic machine perfusion of liver grafts builds on these gains further by increasing the safe use of grafts with suboptimal features, through objective assessment of both hepatocyte and cholangiocyte function. This technology can minimize cold ischemia, but prolong total preservation time, with particular benefits for suboptimal grafts and surgically challenging recipients. In addition to more physiological and favorable preservation conditions for grafts with risk factors for poor outcome, the extended preservation time benefits operative logistics by allowing a careful explant and complicated vascular reconstruction when presented with challenging surgical scenarios. This technology represents a significant advancement in graft preservation techniques and the transplant community must continue to incorporate this technology to ensure the benefits of liver transplant are maximized.
Citations
Altmetric:
Date
2022-05-31
Type
Article
Subject
Microbiology. Immunology
Collections
Citation
Hann A, Nutu A, Clarke G, Patel I, Sneiders D, Oo YH, Hartog H, Perera MTPR. Normothermic Machine Perfusion-Improving the Supply of Transplantable Livers for High-Risk Recipients. Transpl Int. 2022 May 31;35:10460. doi: 10.3389/ti.2022.10460
Journal / Source Title
Transplant International
DOI
10.3389/ti.2022.10460
PMID
35711320
Publisher
Frontiers Media
Publisher’s URL
https://www.frontierspartnerships.org/journals/transplant-international