Hypothermic machine perfusion in liver transplantation

Int J Surg. 2020 Oct:82S:44-51. doi: 10.1016/j.ijsu.2020.04.057. Epub 2020 Apr 28.

Abstract

Dynamic preservation strategies are a promising option to improve graft quality before transplantation, and to extend preservation time for either logistic or treatment reasons. In contrast to normothermic oxygenated perfusion, which intends to mimic physiological conditions in the human body, with subsequent clinical application for up to 24 hrs, hypothermic perfusion is mainly used for a relatively short period with protection of mitochondria and subsequent reduction of oxidative injury upon implantation. The results from two randomized controlled trials, where recruitment has finished are expected this year. Both ex situ perfusion techniques are increasingly applied in clinical transplantation including recent reports on viability assessment, which could open the door for an increased liver utilization in the future.

Keywords: Biliary complications; Hypothermic liver perfusion; Mitochondria; Viability assessment.

Publication types

  • Review

MeSH terms

  • Humans
  • Hypothermia, Induced / methods*
  • Liver / physiopathology
  • Liver / surgery
  • Liver Transplantation*
  • Organ Preservation / methods*
  • Perfusion / methods*
  • Transplants / physiopathology
  • Transplants / surgery
  • Treatment Outcome