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Updated: Jun 15, 2025
Functional Human Liver Preservation and Recovery by Means of Subnormothermic Machine Perfusion
Published on: April 27, 2015
Machine Perfusion Technology Drives a Major Growth Surge in Liver Transplantation
Stalin Canizares1, Adriana Montalvan1, Ritah Chumdermpadetsuk1
1Division of Transplant Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Introduction:
Machine perfusion (MP) opens the possibility to overcome the existing disbalance between supply and demand in liver transplantation. However, it has not been widely adopted across the country. We explored trends of MP adoption in the United States and their effect on center volume (CV).
Methods:
We used the Standard Transplant Analysis and Research datafile from January 2010 to July 2023 to assess CV changes following MP implementation. We classified centers into MP nonusers, low MP users, and high MP (HMP) users. We used interrupted time series analysis to measure changing patterns of HMP CV before and after January 2016, marking the occurrence of the first MP case. High-volume institutions in 2015 were additionally compared to their equivalents in 2022 stratified by their MP status using Wilcoxon rank sum test.
Results:
In our controlled interrupted time series, HMP centers had a sustained yet moderate positive trend in volume (P < 0.001). Comparing only high-volume institutions, we found no difference in the number of transplants performed in 2015 to their equivalents in 2022. In the stratified analysis, only HMP centers had a significant increase in the total number of transplants in 2022 (P = 0.032).
Conclusions:
MP has demonstrated to greatly improve outcomes for recipients of liver transplantation. Here, we demonstrate that centers that incorporate MP could potentially benefit from a growth in their practice as well. Further studies are needed to better characterize the features that drive transplant centers to grow across time.
