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20 April 2018 : Original article  

Does Ischemia Free Liver Procurement Under Normothermic Perfusion Benefit the Outcome of Liver Transplantation?

Qiang Zhao123E, Shanzhou Huang123BE*, Dongping Wang123A, Zhiheng Zhang123B, Linwei Wu123A, Lu Yang4B, Yi Ma123C, Fei Ji123C, Yunhua Tang123D, Linhe Wang123D, Zebin Zhu123D, Yanling Zhu5A, Wei Xiong4D, Maogen Chen123B, Ming Han623C, Jian Zhou123C, Anbin Hu123D, Guodong Wang123D, Xingyuan Jiao123E, Xiaofeng Zhu123A, Weiqiang Ju123E, Zhiyong Guo123E, Xiaoshun He123AE

DOI: 10.12659/AOT.909645

Ann Transplant 2018; 23:258-267

Abstract

BACKGROUND: In contrast to conventional static cold preservation, normothermic machine perfusion (NMP) provides a beneficial alternative preservation of donor livers. However, the liver still suffered cold ischemic injury before attaching to the perfusion device.

MATERIAL AND METHODS: To prevent cold ischemic injury during procurement, we describe a novel procedure called ischemia-free liver procurement (IFLP) under NMP. Two liver grafts were procured from brain death donor under NMP and underwent 2-hour ex vivo NMP followed by 3 and 6 hours of static cold preservation. From procurement to post-transplantation course, evidence was collected to prove that IFLP is safe and benefits recipients.

RESULTS: The post-transplantation course was uneventful, and the liver function tests and histological study revealed minimal hepatocyte and biliary epithelium injury during the preservation.

CONCLUSIONS: This preliminary experience demonstrates the clinical feasibility and safety of IFLP under NMP which offering opportunities to increase the number of donor livers and to improve the organ function.

Keywords: Liver Transplantation, Organ Preservation, Tissue and Organ Procurement

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358