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The Emerging Role of Viability Testing During Liver Machine Perfusion
Isabel M A Brüggenwirth1, Otto B van Leeuwen, Robert J Porte
1Department of SurgerySection of Hepato-Pancreato-Biliary Surgery and Liver Transplantation University Medical Center GroningenUniversity of Groningen Groningen the Netherlands Division of Organ TransplantationDepartment of Surgery UMass Memorial Medical CenterUniversity of Massachusetts Worcester MA.
Assessing donor liver viability with ex situ machine perfusion can help utilize more organs for transplantation. This review explores markers to predict graft success and reduce post-transplant complications.
Area of Science:
- Hepatology
- Transplantation Medicine
- Organ Preservation
Background:
- Significant disparity exists between liver transplant demand and donor organ supply.
- Increasing numbers of donor livers are discarded due to poor organ quality.
- Current methods lack reliable markers to predict liver graft viability and post-transplant outcomes.
Purpose of the Study:
- To review potential viability markers for assessing donor liver function during ex situ machine perfusion.
- To discuss current limitations in using these markers for clinical decision-making.
- To provide recommendations for future application of viability criteria in liver transplantation.
Main Methods:
- Ex situ machine perfusion allows for dynamic assessment of donor livers.
- Evaluation includes organ appearance, hemodynamics, and metabolic/excretory functions.
- Analysis of various viability criteria used in machine perfusion studies.
Main Results:
- Machine perfusion provides data to assess suitability of initially unsuitable donor livers.
- Potential to predict and mitigate postoperative complications like primary nonfunction and cholangiopathy.
- No universally accepted set of criteria for clinical viability assessment currently exists.
Conclusions:
- Ex situ machine perfusion is a promising tool for evaluating donor liver viability.
- Further research is needed to establish standardized viability criteria for clinical use.
- Implementing robust viability assessment can improve liver transplant outcomes and organ utilization.
