Does Ischemia Free Liver Procurement Under Normothermic Perfusion Benefit the Outcome of Liver Transplantation?
Qiang Zhao, Shanzhou Huang, Dongping Wang, Zhiheng Zhang, Linwei Wu, Lu Yang, Yi Ma, Fei Ji, Yunhua Tang, Linhe Wang, Zebin Zhu, Yanling Zhu, Wei Xiong, Maogen Chen, Ming Han, Jian Zhou, Anbin Hu, Guodong Wang, Xingyuan Jiao, Xiaofeng Zhu, Weiqiang Ju, Zhiyong Guo, Xiaoshun He
Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China (mainland)
Ann Transplant 2018; 23:258-267
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