Machine perfusion organ preservation: Highlights from the American Transplant Congress 2023

Area of Science:

• Transplantation Science
• Organ Preservation
• Regenerative Medicine

Background:

• The American Transplant Congress (ATC) 2023 convened leading experts to discuss organ machine perfusion in solid organ and tissue transplantation.
• Over 4500 participants attended, with 85 abstracts focusing on machine perfusion innovations across liver, kidney, heart, and lung transplantation.

Framework:

• Normothermic machine perfusion (NMP) demonstrated potential in reducing ex-situ reperfusion injury in liver transplants.
• Biomarker development for organ quality assessment and machine perfusion's impact on graft survival and ischemic cholangiopathy were key discussion points.
• Novel kidney preservation methods, including subzero storage and pulsatile perfusion, were presented.

Implementation:

• Advancements in heart and lung preservation included metabolic strategies to extend organ viability.
• Machine perfusion applications in pediatric transplantation, multi-visceral organ recovery, and Vascularized Composite Allotransplantation (VCA) were explored.
• Novel technologies for monitoring and optimizing perfusion protocols are under development.

Implications:

• Discussions addressed ethical and legal considerations surrounding machine preservation and the evolving definition of death.
• Machine perfusion is recognized as a transformative technology for enhancing transplant outcomes and increasing the donor organ pool.
• ATC 2023 underscored the global exchange of knowledge and the accelerating role of machine perfusion in transplantation.