Criteria for viability assessment of discarded human donor livers during ex-vivo normothermic machine perfusion

Michael E Sutton,Sanna Op Den Dries,Negin Karimian,Marieke T De Boer,Janneke Wiersema-Buist,Annette S.H Gouw,Henri G.D Leuvenink,Ton Lisman,Robert J Porte

doi:10.1016/j.trim.2014.11.162

Michael E Sutton, Sanna Op Den Dries + Show 7 more

Open Access

https://doi.org/10.1016/j.trim.2014.11.162

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Abstract

Criteria for viability assessment of discarded human donor livers during ex-vivo normothermic machine perfusion

Highlights

Donor liver shortage remains a limiting factor in liver transplant programs in most parts of the world
First aim of this study was to determine whether bile production is a suitable marker of hepatic viability that can be used during normothermic oxygenated machine perfusion (NMP) to discriminate a potentially transplantable from a nontransplantable graft
Machine perfusion of donor livers is receiving increasing attention as experimental studies have suggested that this method can provide better protection during storage and transportation, compared to static cold storage [10], [11], [12]

Summary

Introduction

Donor liver shortage remains a limiting factor in liver transplant programs in most parts of the world. The types of ECD livers most frequently considered for transplantation are livers with mildmoderate steatosis, livers from older donors or donors with a high body mass index, and livers donated after cardiac death (DCD) [1], [2], [3]. Livers from ECD donors are increasingly considered for transplantation, many of them are still declined. A recent study in the US has shown that the proportion of donor livers not used for transplantation is increasing since 2004 [4]. The proportion of nonuse attributable to DCD increased from 9% in 2004 to 28% in 2010, probably because in many cases the risk of early graft failure after transplantation is considered to be too high [4]

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