Related Experiment Video
Updated: Oct 18, 2026
Functional Human Liver Preservation and Recovery by Means of Subnormothermic Machine Perfusion
Published on: April 27, 2015
Impact of Machine Perfusion on Liver Transplantation for Hepatocellular Carcinoma
Luckshi Rajendran1, Rikako Oki1, Ahmed Nassar1
1Division of Transplant Surgery, Henry Ford Hospital, Detroit, MI, USA.
Introduction:
Ischemic reperfusion injury (IRI) during liver transplantation is associated with recurrence of hepatocellular carcinoma (HCC). Machine perfusion (MP) is associated with a decreased risk of IRI complications. Our study evaluated the role of MP in post-transplant oncologic outcomes in patients with HCC.
Methods:
Adults with HCC transplanted between 2015-2025 from the United Network for Organ Sharing database were divided into MP and no-MP groups. Propensity score matching (PSM) was also performed. Post-transplant HCC recurrence (competing risk) and overall survival (OS) were assessed. Subgroup analysis was performed in populations within and beyond the Milan criteria.
Results:
A total of 19,466 patients were included in this study. MP was used in 1,392 (7.2%). The MP group had shorter waitlist times, older donors, and more frequent DCDs (p=0.001). After PSM, 512 patients were included in each group (336 patients within Milan criteria in each). In the population beyond Milan after PSM (n=352), MP use was associated with a reduced risk of 1-year and 3-year HCC recurrence (adjusted hazard ratio (aHR) 0.09, p=0.02; aHR 0.27, p=0.02). MP use was not associated with the 1-year or 3-year OS (aHR 1.34, p=0.64; aHR 1.32, p=0.54).
Conclusions:
MP may potentially reduce the risk of HCC recurrence in recipients beyond Milan criteria, without significant difference in OS. However, as MP utilization increases, further validation into the role of MP and oncologic outcomes in larger cohort studies are required.
