Machine Perfusion for the Assessment and Resuscitation of Marginal Donors in Liver Transplantation

AbstractA limited supply of donor livers has led many centers to use marginal liver allografts for transplantation with increasing frequency. These allografts are at increased risk for both primary non-function, early allograft dysfunction, and other recipient complications following transplantation. Machine perfusion preservation is an emerging technology that limits the ischemia-reperfusion injury sustained during allograft preservation and may lead to improved outcomes following liver transplantation. While several clinical series has shown a benefit of machine perfusion in both standard and extended criteria donors, no guidelines exist on how to assess the viability high-risk organs that might otherwise be turned down for transplantation. In this review, we highlight the current state of the art in allograft preservation using machine perfusion in liver transplantation. We explore the various methods available to assess allograft viability during machine perfusion. As the transplant community continues to push the boundaries and include allografts traditionally unfit for transplantation, it will be important to establish clear criteria to distinguish transplantable from non-transplantable allografts.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research