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Related Experiment Video

Updated: Jun 4, 2025

Ex Situ Normothermic Machine Perfusion of Donor Livers
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A Novel Machine Perfusion System for Enhancing Hepatic Microcirculation Perfusion.

Lin Fan1, Haoyang Xia1, Guizhu Peng1

  • 1Hubei Provincial Clinical Research Center for Natural Polymer Biological Liver, Hubei Key Laboratory of Medical Technology on Transplantation, National Quality Control Center for Donated Organ Procurement, Transplant Center of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.

Artificial Organs
|December 31, 2024
PubMed
Summary

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A novel hypothermic oxygenated perfusion (HOPE) system improved outcomes for donor livers after cardiac death (DCD). The new HOPE S3 system significantly enhanced liver survival and reduced injury, offering a promising solution for salvaging compromised DCD liver grafts.

Area of Science:

  • Transplantation immunology
  • Organ preservation
  • Surgical innovation

Background:

  • Machine perfusion is a key strategy for preserving liver grafts donated after cardiac death (DCD).
  • Severe warm ischemic injury poses significant risks to DCD liver graft viability.
  • Novel perfusion techniques are needed to mitigate these risks and improve transplant outcomes.

Purpose of the Study:

  • To develop and validate a novel machine perfusion system for salvaging severe DCD liver grafts.
  • To evaluate the efficacy of the new system in mitigating risk factors associated with DCD livers.
  • To compare the novel system's performance against conventional methods and static cold storage.

Main Methods:

  • Development of a novel hypothermic oxygenated perfusion (HOPE) system (HOPE S3) with cardiac cycle emulation.
Keywords:
donation after cardiac deathhepatic microcirculationhepatic sinusoidshypothermic oxygenated perfusionliver transplantationorgan recovery

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  • Evaluation in rat models using healthy livers with HTK solution and DCD livers with 60-min warm ischemia.
  • Assessment of outcomes through macroscopic, microscopic, molecular analyses, and orthotopic liver transplantation (OLT).

    • Main Results:

    • HOPE-perfused DCD livers showed reduced injury and improved survival versus static cold storage after warm ischemia.
    • The novel HOPE S3 system achieved a 67% animal survival rate after 60-min warm ischemia.
    • HOPE S3 protected against hepatocyte and non-parenchymal cell injury, with enhanced microcirculation and preserved morphology.

    Conclusions:

    • The novel machine perfusion system effectively enhances and standardizes liver perfusion.
    • This system shows promise for revitalizing DCD liver grafts with severe warm ischemic injuries.
    • The HOPE S3 system represents a significant advancement in organ preservation for DCD liver transplantation.