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Updated: Jan 9, 2026

Functional Human Liver Preservation and Recovery by Means of Subnormothermic Machine Perfusion

Functional Human Liver Preservation and Recovery by Means of Subnormothermic Machine Perfusion

Published on: April 27, 2015

Quasi Ischemia-Free Liver Procurement: A Novel Technique to Decrease Graft Injury With Normothermic Machine

Cristiano Quintini¹, Teresa Diago Uso¹, Koji Hashimoto²

¹Cleveland Clinic Abu Dhabi, Department of Liver Transplantation, Abu Dhabi, UAE.

Artificial Organs

|December 5, 2025

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A novel quasi ischemia-free liver procurement technique minimizes organ damage by avoiding cold storage. This method successfully preserved and transplanted a liver graft, showing excellent viability and leading to a good patient outcome.

Area of Science:

Transplantation Surgery
Organ Preservation
Machine Perfusion

Background:

Normothermic machine perfusion aids liver preservation and viability assessment.
Standard protocols involve cooling/rewarming, risking double ischemia/reperfusion injury and graft dysfunction.
Marginal liver grafts are often discarded due to preservation concerns.

Purpose of the Study:

To introduce a novel surgical technique for liver procurement that minimizes ischemia-reperfusion injury.
To evaluate the efficacy of quasi ischemia-free liver procurement in a clinical setting.
To assess graft viability and transplant outcomes using this innovative approach.

Main Methods:

A quasi ischemia-free liver procurement technique was developed to eliminate cold ischemia.

Keywords:

education ex‐situ ischemia‐free liver machine perfusion technique transplantation viability

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Last Updated: Jan 9, 2026

Functional Human Liver Preservation and Recovery by Means of Subnormothermic Machine Perfusion

Functional Human Liver Preservation and Recovery by Means of Subnormothermic Machine Perfusion

Published on: April 27, 2015

Ex Situ Normothermic Machine Perfusion of Donor Livers

Ex Situ Normothermic Machine Perfusion of Donor Livers

Published on: May 26, 2015

Porcine Normothermic Isolated Liver Perfusion

Porcine Normothermic Isolated Liver Perfusion

Published on: June 9, 2023

The technique was applied to an orphan liver graft from a deceased donor.

Ex-situ normothermic perfusion was initiated within minutes of graft retrieval without cooling.

Main Results:

The liver graft demonstrated excellent viability during nearly 4 hours of normothermic perfusion.
Key indicators of viability included rapid lactate clearance, stable transaminases, and good bile production.
The recipient had an uneventful recovery with immediate graft function and was discharged on postoperative day 8.

Conclusions:

Quasi ischemia-free liver procurement offers a simpler alternative to traditional ischemia-free transplantation.
This technique has the potential to simplify the liver implantation process.
The approach shows promise for enhancing outcomes in liver transplantation, especially for marginal grafts.