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Functional Human Liver Preservation and Recovery by Means of Subnormothermic Machine Perfusion
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Liver perfusion devices: how close are we to widespread application?
Amelia J Hessheimer1, Constantino Fondevila
1General and Digestive Surgery, Institut de Malalties Digestives i Metabòliques (IMDiM), Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain.
Current Opinion in Organ Transplantation
|December 13, 2016
Summary
Ex-situ liver machine perfusion, including hypothermic (HMP) and normothermic (NMP) methods, shows promise for improving liver transplantation. Further high-level evidence is needed to support its broader clinical use in liver transplants.
Area of Science:
- Hepatology
- Transplantation Science
- Surgical Innovation
Background:
- Ex-situ liver machine perfusion is gaining traction to enhance donor liver quality and expand liver transplantation eligibility.
- This review examines the experimental foundations and recent clinical advancements in liver machine perfusion.
Purpose of the Study:
- To evaluate the experimental evidence supporting liver machine perfusion.
- To assess the significance of recent clinical applications of liver machine perfusion.
Main Methods:
- Review of experimental studies on liver machine perfusion at various temperatures.
- Analysis of clinical data from phase I trials of hypothermic machine perfusion (HMP) and normothermic machine perfusion (NMP).
Main Results:
- Clinical applications have utilized HMP (0-12°C) and NMP (35-38°C).
- Phase I trials confirm the feasibility of both HMP and NMP in clinical settings.
- Normothermic machine perfusion (NMP) has shown potential in evaluating initially discarded livers for viability.
Conclusions:
- Initial clinical outcomes for liver machine perfusion are encouraging.
- Higher-level evidence is required to advocate for widespread adoption in human liver transplantation.
