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Updated: Aug 10, 2026
Ex Situ Normothermic Machine Perfusion of Donor Livers
Published on: May 26, 2015
Back Bench Time: The Hidden Factor of Ischemia in Liver Transplantation
Alexzandria Karina Khan1, Terri Gotschall1, Mihnea Ioan Ionescu
1Miami Transplant Institute, Jackson Health System, Miami, FL, United States
Insights
Back bench time (BBT) may significantly impact liver transplant outcomes by affecting warm (WIT) and cold ischemia time (CIT). Further research is needed to establish safe BBT thresholds and understand its influence on graft survival.
Area of Science:
- Transplantation Surgery
- Organ Preservation
- Ischemia Research
Background:
- Ischemia time is a critical factor influencing liver transplant success.
- Prolonged warm ischemia time (WIT) and cold ischemia time (CIT) negatively affect patient survival.
- Back bench time (BBT) is a potential contributor to both WIT and CIT.
Purpose of the Study:
- To investigate the role of back bench time (BBT) as a determinant of post-transplant complications.
- To systematically review existing literature on BBT in liver transplantation.
- To identify BBT as a potentially modifiable factor in organ preservation.
Main Methods:
- Systematic literature search across major databases.
- Inclusion of studies comparing normothermic machine perfusion and static cold storage.
- Analysis focused on WIT, CIT, and post-transplant outcomes.
Main Results:
- Only two studies out of 18 selected articles specifically addressed BBT.
- BBT was identified as a factor potentially influencing WIT and CIT.
- Limited data exists on the direct impact of BBT on post-transplant outcomes.
Conclusions:
- BBT is a modifiable component of ischemia during liver transplantation.
- Surgeon experience may influence BBT.
- Further in-depth studies are required to determine safe BBT thresholds and its precise effect on outcomes like early allograft dysfunction (EAD), وهو ما يعني (IC), and graft survival.
Abstract:
Ischemia time is a well-established determinant of liver transplant outcomes. Patient survival is substantially affected by prolonged warm (WIT) and cold ischemia time (CIT) of the graft during liver transplant. One component that may be a contributing factor to both WIT and CIT is back bench time (BBT). We have identified BBT as a potentially significant underlying cause of post transplant complications. A literature search was performed using the major available databases. Articles comparing grafts using normothermic machine perfusion and static cold storage with measured WIT and CIT, and post-transplant outcomes, were included. A total of 18 studies were selected; however, we were only able to identify two studies that refer to BBT. In this systematic review, we conclude BBT is a modifiable factor of ischemia that may be impacted by the surgeon experience and requires more in depth studies to fully understand a safe threshold and its effect on post transplant outcomes such as EAD, IC, and graft survival.
