Normothermic machine perfusion of explanted livers: Exploratory study of an alternative translational model for end‐stage liver disease
Rachel Todd, L. Leonie van Leeuwen, Matthew Holzner, Leona Kim‐Schluger, Maria Isabel Fiel, Daniel Puleston, Sander S. Florman, M. Zeeshan AkhtarAbstract
Background
Normothermic machine perfusion (NMP) is a technique for donor liver preservation and assessment in transplantation. NMP has gained momentum recently by enabling safer use of higher risk organs via organ viability assessment. It also offers a platform for investigating ex vivo organ biology.
Methods
In this exploratory study, we completed a complex vascular reconstruction of explanted, diseased livers from patients undergoing transplantation and then perfused them normothermically on a closed perfusion circuit. We compared these livers to non‐diseased donor livers via perfusate samples collected during perfusion.
Results
Five hepatectomized grafts and eight donor livers were perfused for 1 h or longer. Four hepatectomized livers cleared lactate, and all consumed glucose; all control livers cleared lactate, and seven utilized glucose. Significantly higher portal vein flows were achieved in the control group.
Conclusions
Our findings illustrate the feasibility of using closed‐circuit NMP as a platform to study hepatectomized organs, which could reshape the research landscape in mechanisms of disease and applied therapeutics for patients with end‐stage liver disease.