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Related Experiment Video

Updated: May 20, 2025

Ex Situ Normothermic Machine Perfusion of Donor Livers
12:13

Ex Situ Normothermic Machine Perfusion of Donor Livers

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Enhancing Organ Availability: Increased DCD Liver Utilization Following Implementation of a Normothermic Machine

Marwan T Idrees1, Gabriel Land1, Nicky Kathuria1

  • 1Queensland Liver Transplant Unit, Princess Alexandra Hospital, Queensland, Australia.

ANZ Journal of Surgery
|May 19, 2025
PubMed
Summary
This summary is machine-generated.

Normothermic machine perfusion (NMP) significantly increased the utilization of livers from donation after circulatory death (DCD) in Queensland. This approach improved DCD liver offer acceptance and implantation rates without compromising graft outcomes.

Keywords:
DCDNMPliver transplantationnormothermic machine perfusionorgan retrieval

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Area of Science:

  • Transplantation Medicine
  • Organ Preservation Technology
  • Hepatology

Background:

  • Donation after circulatory death (DCD) liver utilization in Australia lags behind international benchmarks.
  • Concerns regarding early graft dysfunction and ischemic cholangiopathy limit DCD liver transplantation.
  • Limited organ availability and complex logistics further challenge DCD liver utilization.

Purpose of the Study:

  • To evaluate the impact of introducing normothermic machine perfusion (NMP) on DCD liver utilization.
  • To compare DCD liver utilization rates before and after NMP implementation.
  • To assess graft outcomes associated with NMP preservation of DCD livers.

Main Methods:

  • Retrospective historical-control study comparing two eras: static cold storage (SCS) and NMP.
  • Included all DCD liver activity in Queensland from June 2015 to June 2021.
  • Utilized DonateLife Queensland and Princess Alexandra Hospital electronic medical records for data collection.

Main Results:

  • The NMP era demonstrated significantly higher rates of medically suitable DCD offers (90.5% vs. 66.1%) and formal DCD offers (88.1% vs. 61.0%).
  • DCD planned retrieval rates (56.6% vs. 23.7%) and implantation rates per offer (18.8% vs. 5.9%) were substantially higher in the NMP era.
  • Despite increased utilization and higher DCD risk scores, NMP did not increase rates of early allograft dysfunction, primary nonfunction, or ischemic cholangiopathy.

Conclusions:

  • Normothermic machine perfusion (NMP) significantly enhances the utilization of livers from donation after circulatory death (DCD).
  • NMP facilitates the acceptance and transplantation of previously unsuitable DCD livers.
  • This technology improves DCD liver utilization without adversely affecting early graft function or survival.