2024, Volume 32, Issue 1
Engineering >> 2024, Volume 32, Issue 1 doi: 10.1016/j.eng.2023.11.003
Machine Perfusion Plus for Extended Criteria Donor Liver Grafts: Making Every Liver Count
a Zhejiang University School of Medicine, Hangzhou 310058, China
b Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Hangzhou 310006, China
c Department of Surgery, University of Cambridge & NIHR Cambridge Biomedical Research Centre, Cambridge CB2 2QQ, UK
d Department of Surgery, Cambridge University Hospitals & NHS Foundation Trust, Cambridge CB2 2QQ, UK
e Institute of Organ Transplantation, Zhejiang University, Hangzhou 310003, China
# These authors contributed equally to this work and share the first authorship.
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Abstract
Transplantation represents the most effective treatment for end-stage liver diseases but is limited by the shortage of healthy donor organs. Extended criteria donor (ECD) liver grafts are increasingly utilized in clinical practice to mitigate this challenge. However, impaired ischemic tolerance of these grafts jeopardizes organ viability during cold storage. Machine perfusion (MP) was designed to improve organ preservation and reduce posttransplant complications. Nevertheless, it is increasingly evident that MP alone may not preserve ECD grafts optimally. Increasing emphasis has thus been placed on modified MP strategies, including the use of different perfusates, modified perfusion modalities, and different therapeutic interventions. Here, we introduce a novel term, “MP Plus,” denoting these additional strategies that are designed to restore organ function and potentially enable regeneration of ECD grafts. In this review, we summarize the existing and potential modified MP strategies and discuss their advantages in reconditioning different ECD grafts in clinical settings.
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