Recent developments in liver transplantation and evolving hypothermic machine perfusion (HMP) technology were reviewed by Bae, et al in 2012. Both experimental and clinical data have demonstrated an advantage of HMP over static cold storage for both liver allograft preservation and early allograft function. Furthermore, the molecular advantages of liver HMP include energy reconstitution, delivery of oxygen and metabolic substrates and attenuation of ischemia reperfusion injury markers.
Liver HMP allows for the preservation of microvasculature, washout of cellular waste product, targeted delivery of therapeutic agents and potential assessment of graft viability.
The authors concluded that perfusing livers holds promise for expanding the donor pool by reconditioning previously rejected livers such as steatotic livers and allografts from donation after cardiac death.
Bae C, et al. Curr Opin Organ Transplant. 2012;17:137–42.