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

Yuri L. Boteon; Simon Afford; Hynek Mergental

doi:10.1007/s40472-018-0188-7

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

Yuri L. Boteon, Simon Afford, Hynek Mergental

Immunology and Immunotherapy

Research output: Contribution to journal › Review article › peer-review

20 Citations (Scopus)

195 Downloads (Pure)

Abstract

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 language	English
Pages (from-to)	113-120
Number of pages	8
Journal	Current Transplantation Reports
Volume	5
Issue number	2
Early online date	20 Mar 2018
DOIs	https://doi.org/10.1007/s40472-018-0188-7
Publication status	Published - 1 Jun 2018

Bibliographical note

Already published online (20 March 2018)

Keywords

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

Access to Document

10.1007/s40472-018-0188-7Licence: Creative Commons: Attribution (CC BY)

Boteon_et_al_Pushing_the_limits_Current_Transplantation_Reports_2018
Publihsed in Current transplantation Reports on 20/03/2018 DOI: 10.1007/s40472-018-0188-7
Final published version, 436 KBLicence: Creative Commons: Attribution (CC BY)

https://link.springer.com/article/10.1007%2Fs40472-018-0188-7Licence: Creative Commons: Attribution (CC BY)

Cite this

@article{a366bd3125a7454581d754671912a7ff,

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

abstract = "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.",

keywords = "Liver, Perfusion, high-risk liver preservation, liver preservation , organ utilisation , extended criteria donor , therapeutic intervention , functional assessment",

author = "Boteon, {Yuri L.} and Simon Afford and Hynek Mergental",

note = "Already published online (20 March 2018)",

year = "2018",

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doi = "10.1007/s40472-018-0188-7",

language = "English",

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TY - JOUR

T1 - Pushing the Limits:

T2 - Machine Preservation of the Liver as a Tool to Recondition High-Risk Grafts

AU - Boteon, Yuri L.

AU - Afford, Simon

AU - Mergental, Hynek

N1 - Already published online (20 March 2018)

PY - 2018/6/1

Y1 - 2018/6/1

N2 - 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.

AB - 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.

KW - Liver

KW - Perfusion

KW - high-risk liver preservation

KW - liver preservation

KW - organ utilisation

KW - extended criteria donor

KW - therapeutic intervention

KW - functional assessment

UR - https://www.ncbi.nlm.nih.gov/pubmed/?term=Pushing+the+Limits%3A+Machine+Preservation+of+the+Liver+as+a+Tool+to+Recondition+High-Risk+Grafts

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DO - 10.1007/s40472-018-0188-7

M3 - Review article

C2 - 29774176

SN - 2196-3029

VL - 5

SP - 113

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JO - Current Transplantation Reports

JF - Current Transplantation Reports

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ER -