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Updated: Dec 30, 2025

Functional Human Liver Preservation and Recovery by Means of Subnormothermic Machine Perfusion
Published on: April 27, 2015
Liver transplantation: current and future
Christopher B Hughes1, Abhinav Humar2
1Starzl Transplantation Institute, University of Pittsburgh Medical Center, 3459 Fifth Avenue, MUH N725, Pittsburgh, PA, 15213, USA. hughescb@upmc.edu.
Purpose:
The aim of this paper is to summarize the allocation challenges facing the field of liver transplantation while providing examples of the expansion of indications for the procedure.
Methods:
UNOS allocation policy was reviewed as well as the recent literature describing expanded criteria for recipient candidate selection.
Results:
Liver allocation policy changes for deceased-donor organs remain gridlocked in legal and bureaucratic red tape. Meanwhile, the indications for liver transplantation are being expanded to include acute alcoholic hepatitis, intrahepatic cholangiocarcinoma, and colorectal metastasis, previously viewed as absolute contraindications, but under strict selection criteria.
Conclusions:
Attempting to meet the demand for livers, transplant centers are increasingly turning to living donor liver transplantation, protocols such as HCV-positive to HCV-negative transplants, and machine perfusion of marginal organs.
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