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Updated: Aug 7, 2025
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Ex Situ Normothermic Machine Perfusion of Donor Livers
Published on: May 26, 2015
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Normothermic machine perfusion for older transplant recipients
Andrew D Shubin1, Cyrus A Feizpour1, Christine S Hwang1
1Department of Surgery, Transplant Division, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Artificial Organs
|March 12, 2023
Summary
Normothermic machine perfusion (NMP) offers a promising solution for elderly liver transplant recipients, utilizing marginal donor grafts effectively. This technique improves outcomes and expands the donor pool for this growing patient population.
Area of Science:
- Transplantation research
- Organ preservation techniques
- Geriatric medicine
Background:
- Elderly patients (≥65 years) are a growing demographic for liver transplantation.
- This population faces higher waitlist removal rates.
- Marginal donor livers pose challenges for elderly recipients.
Purpose of the Study:
- To evaluate the impact of Normothermic Machine Perfusion (NMP) on liver transplant outcomes in elderly recipients.
- To compare NMP with traditional cold static storage nationally and institutionally.
Main Methods:
- Utilized the UNOS/SRTR database (2016-2022) and institutional data (2018-2020).
- Compared elderly recipients receiving NMP-preserved allografts versus those receiving static cold storage.
- Analyzed donor characteristics and recipient clinical outcomes.
Main Results:
- NMP donors were older and more likely to be from Donation after Circulatory Death (DCD) sources, with a higher Donor Risk Index (DRI).
- NMP recipients had similar allograft survival and shorter hospital stays despite increased graft marginality.
- Institutional data showed comparable length of stay, complication rates, and readmissions for NMP recipients.
Conclusions:
- Normothermic machine perfusion (NMP) can mitigate donor risk factors, potentially expanding the donor pool for elderly liver transplant candidates.
- NMP demonstrates potential benefits for older recipients, warranting consideration in clinical application.
