Pushing the Limits: Machine Preservation of the Liver as a Tool to Recondition High-Risk Grafts

Yuri L. Boteon, Simon Afford, Hynek Mergental

Research output: Contribution to journalReview articlepeer-review

20 Citations (Scopus)
190 Downloads (Pure)


Purpose of the Review: Machine perfusion (MP) is a novel technology recently introduced in liver transplantation, redefining the current practice of organ preservation and pushing the limits of high-risk liver utilisation. This review highlights the key benefits of machine perfusion over conventional static cold storage (SCS), demonstrated in human liver research and clinical transplants.

Recent Findings: The first clinical trials have demonstrated both safety and feasibility of MP. The most recent transplant series and result from a randomised trial suggest the technology is superior to SCS. The key benefits include extended period of organ preservation, decreased incidence of early allograft dysfunction and reduction of biliary complications. Normothermic liver perfusion allows viability testing to guide transplantability of the highest-risk organs. This technology also provides opportunities for therapeutic interventions to improve liver function and quality in organs that are currently declined for clinical use.

Summary: Machine perfusion is likely to transform the liver preservation pathway and to improve utilisation of high-risk grafts.

Original languageEnglish
Pages (from-to)113-120
Number of pages8
JournalCurrent Transplantation Reports
Issue number2
Early online date20 Mar 2018
Publication statusPublished - 1 Jun 2018

Bibliographical note

Already published online (20 March 2018)


  • Liver
  • Perfusion
  • high-risk liver preservation
  • liver preservation
  • organ utilisation
  • extended criteria donor
  • therapeutic intervention
  • functional assessment


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