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An Iterative Design Approach to Development of an Ex Situ Normothermic Multivisceral Perfusion Platform
L Leonie van Leeuwen1, Matthew L Holzner1, Ceilidh McKenney1
1Organ Perfusion Unit, Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, 1468 Madison Ave, New York City, NY 10029, USA.
Journal of Clinical Medicine
|July 12, 2025
Summary
This study developed a new platform for multivisceral normothermic machine perfusion (NMP), successfully preserving multiple organs together for up to 8 hours, showing improved viability and potential for long-term organ preservation.
Area of Science:
- Transplantation Science
- Organ Perfusion Technology
- Surgical Innovation
Background:
- Normothermic machine perfusion (NMP) faces challenges in extending organ preservation times.
- Preserving multiple organs simultaneously in a multivisceral block is a potential solution.
- Establishing an ex situ platform for multivisceral organ perfusion is crucial.
Purpose of the Study:
- To develop and evaluate a platform for ex situ multivisceral organ perfusion.
- To assess the feasibility and efficacy of perfusing multiple abdominal organs together.
- To optimize NMP protocols for extended organ preservation.
Main Methods:
- Utilized Yorkshire pig multivisceral grafts (liver, kidneys, pancreas, spleen, intestine).
- Iteratively designed and tested three generations (Gen 1-3) of perfusion circuits.
- Assessed organ function and hemostatic parameters during NMP with autologous blood perfusate.
Main Results:
- Generation 3 demonstrated significantly improved aortic flow and reduced resistance compared to Gen 1.
- Gen 3 showed increased urine output, oxygen consumption, and more physiological perfusate pH.
- Perfusate lactate levels decreased, and cellular injury trended lower in Gen 3, indicating enhanced organ viability.
Conclusions:
- Demonstrated the feasibility of abdominal multivisceral NMP for up to 8 hours.
- Optimized perfusion setup (Gen 3) supported organ viability through adequate flow and metabolic stability.
- Multivisceral NMP presents a promising platform for advancing long-term organ preservation strategies.
