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Related Experiment Video

Updated: Aug 30, 2025

Ex Situ Normothermic Machine Perfusion of Donor Livers
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Predicting Early Allograft Function After Normothermic Machine Perfusion.

Christopher J E Watson1,2,3,4, Rohit Gaurav4, Corrina Fear4

  • 1Department of Surgery, University of Cambridge, Level E9, Addenbrooke's Hospital, Cambridge, United Kingdom.

Transplantation
|August 31, 2022
PubMed
Summary
This summary is machine-generated.

Assessing donor liver viability during normothermic ex situ perfusion is crucial. Key perfusate markers like alanine transaminase, lactate, and pH predict early allograft function, guiding transplant decisions.

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Last Updated: Aug 30, 2025

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Area of Science:

  • Transplantation Medicine
  • Organ Preservation
  • Hepatology

Background:

  • Normothermic ex situ liver perfusion (NEP) is vital for donor liver assessment.
  • Limited evidence exists for NEP viability and early allograft function prediction criteria.

Purpose of the Study:

  • To identify perfusate variables from NEP that best predict the Model for Early Allograft Function (MEAF) score.
  • To refine criteria for donor liver viability assessment using NEP.

Main Methods:

  • Analysis of perfusate variables from 203 livers undergoing NEP.
  • Multivariable analysis to correlate perfusate markers with MEAF score.
  • Comparison of outcomes for donation after circulatory death (DCD) and donation after brain death (DBD) livers.

Main Results:

  • 2-hour alanine transaminase, 2-hour lactate, 11-29 mmol supplementary bicarbonate (first 4h), and peak bile pH predicted MEAF score.
  • 154 of 203 perfused livers were transplanted.
  • Non-anastomotic biliary strictures occurred in 11% of transplants.

Conclusions:

  • Confirms the importance of 2-hour alanine transaminase, lactate, and bicarbonate for liver assessment during NEP.
  • Highlights the need for caution when using lactate as a sole viability indicator.
  • Suggests cholangiocyte function markers may aid in predicting early allograft function.