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Related Experiment Video

Updated: Sep 4, 2025

Functional Human Liver Preservation and Recovery by Means of Subnormothermic Machine Perfusion
08:54

Functional Human Liver Preservation and Recovery by Means of Subnormothermic Machine Perfusion

Published on: April 27, 2015

17.0K

Viability testing during liver preservation.

Damiano Patrono1, Caterina Lonati2, Renato Romagnoli1

  • 1General Surgery 2U - Liver Transplant Unit. Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino - University of Turin, Turin.

Current Opinion in Organ Transplantation
|July 20, 2022
PubMed
Summary

Assessing liver viability during machine perfusion (MP) in transplantation is crucial. Current methods combine multiple parameters but are heterogeneous, with perfusate flavin mononucleotide showing promise in hypothermic MP.

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Technique of Subnormothermic Ex Vivo Liver Perfusion for the Storage, Assessment, and Repair of Marginal Liver Grafts

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Last Updated: Sep 4, 2025

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Technique of Subnormothermic Ex Vivo Liver Perfusion for the Storage, Assessment, and Repair of Marginal Liver Grafts
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Area of Science:

  • Hepatology
  • Transplantation Medicine
  • Organ Preservation

Background:

  • Machine perfusion (MP) is increasingly used for liver transplantation.
  • Assessing liver graft viability is a primary indication for MP.
  • Standardized viability criteria are still evolving.

Purpose of the Study:

  • To review the rationale, evolution, and limitations of current liver viability assessment criteria during MP.
  • To propose a framework for future research in this area.

Main Methods:

  • Review of existing literature on liver viability assessment during normothermic and hypothermic MP.
  • Analysis of parameters including perfusate and bile composition, vascular flows, and macroscopic appearance.
  • Exploration of emerging biomarkers such as perfusate flavin mononucleotide.

Main Results:

  • Normothermic MP viability assessment commonly integrates perfusate/bile analysis, flow dynamics, and visual inspection.
  • Protocols for viability assessment are heterogeneous and have evolved significantly.
  • Perfusate flavin mononucleotide shows potential as a biomarker for mitochondrial function during hypothermic MP.
  • Current studies often face limitations like small sample sizes, lack of multicenter validation, and subjective parameter interpretation.

Conclusions:

  • MP introduces complexity to liver graft quality assessment.
  • Understanding the physiology behind MP parameters is essential for accurate interpretation.
  • Despite advances, donor-recipient matching and operational factors remain critical alongside MP viability assessment.