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Ex Situ Normothermic Machine Perfusion of Donor Livers |
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| Authors: | Negin Karimian Alix P.M. Matton Andrie C. Westerkamp Laura C. Burlage Sanna op den Dries Henri G.D. Leuvenink Ton Lisman Korkut Uygun James F. Markmann Robert J. Porte |
| Affiliation: | 1.Section of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen;2.Surgical Research Laboratory, Department of Surgery, University of Groningen, University Medical Center Groningen;3.Center of Engineering in Medicine/Surgical Services, Massachusetts General Hospital, Harvard Medical School, and Shriners Burns Hospital;4.Division of Transplantation, Department of Surgery, Massachusetts General Hospital, Harvard Medical School |
| Abstract: | In contrast to conventional static cold preservation (0-4 °C), ex situ machine perfusion may provide better preservation of donor livers. Continuous perfusion of organs provides the opportunity to improve organ quality and allows ex situ viability assessment of donor livers prior to transplantation. This video article provides a step by step protocol for ex situ normothermic machine perfusion (37 °C) of human donor livers using a device that provides a pressure and temperature controlled pulsatile perfusion of the hepatic artery and continuous perfusion of the portal vein. The perfusion fluid is oxygenated by two hollow fiber membrane oxygenators and the temperature can be regulated between 10 °C and 37 °C. During perfusion, the metabolic activity of the liver as well as the degree of injury can be assessed by biochemical analysis of samples taken from the perfusion fluid. Machine perfusion is a very promising tool to increase the number of livers that are suitable for transplantation. |
| Keywords: | Medicine Issue 99 Machine perfusion liver transplantation preservation normothermic hypothermic human donor liver |