Normothermic liver preservation, current status and future directions. Issue 3 (June 2018)

• Record Type: Journal Article
• Authors: Detelich, Danielle; Markmann, James F.
• Is Part Of: Current opinion in organ transplantation. Volume 23:Issue 3(2018:Jun.)
• Publication Date: 2018-06
• Subjects: extended preservation -- graft modification -- liver transplantation -- normothermic machine perfusion -- reconditioning -- viability assessment; Transplantation of organs, tissues, etc -- Periodicals; Immunosuppression -- Periodicals; Transplantation immunology -- Periodicals; 617.954
• DOI: 10.1097/MOT.0000000000000531
• Languages: English
• ISSNs: 1087-2418

Abstract

Abstract : Purpose of review: Normothermic machine perfusion (NMP) is an emerging technology for liver preservation. Early clinical results demonstrate beneficial effects in reconditioning high-risk grafts. This review discusses the role of normothermic perfusion as a tool to assess graft viability and as a platform for graft intervention and modification. Recent findings: The potential benefits of NMP extend far beyond organ reconditioning. Recent pilot studies have identified clinically relevant viability criteria, which now require validation in large randomized control trials prior to implementation. Furthermore, preclinical studies demonstrate tremendous potential for NMP as a method to extend the preservation period, thus improving transplant logistics as well as serve as a platform for graft-targeted interventions to optimize the preservation period. Summary: NMP is a multifunctional tool with potential to transform liver preservation and the field of transplantation. Large clinical trials are necessary to optimize perfusion protocols, clarify indications for NMP therapy and justify use as the standard preservation modality.