Pushing the Limits: Machine Preservation of the Liver as a Tool to Recondition High-Risk Grafts

被引：25
作者：
Boteon Y.L. [1 ,2 ]
Afford S.C. [2 ]
Mergental H. [1 ,2 ]
机构：
[1] Liver Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham
[2] National Institute for Health Research, Birmingham Liver Biomedical Research Centre, Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham
来源：
Current Transplantation Reports | 2018年 / 5卷 / 2期
基金：
英国惠康基金;
关键词：
Extended criteria donor; Functional assessment; Liver preservation; Organ utilisation; Therapeutic intervention;
D O I：
10.1007/s40472-018-0188-7
中图分类号：
学科分类号：
摘要：
Purpose of the Review: Machine perfusion (MP) is a novel technology recently introduced in liver transplantation, redefining the current practice of organ preservation and pushing the limits of high-risk liver utilisation. This review highlights the key benefits of machine perfusion over conventional static cold storage (SCS), demonstrated in human liver research and clinical transplants. Recent Findings: The first clinical trials have demonstrated both safety and feasibility of MP. The most recent transplant series and result from a randomised trial suggest the technology is superior to SCS. The key benefits include extended period of organ preservation, decreased incidence of early allograft dysfunction and reduction of biliary complications. Normothermic liver perfusion allows viability testing to guide transplantability of the highest-risk organs. This technology also provides opportunities for therapeutic interventions to improve liver function and quality in organs that are currently declined for clinical use. Summary: Machine perfusion is likely to transform the liver preservation pathway and to improve utilisation of high-risk grafts. © 2018, The Author(s).
引用
收藏
页码：113 / 120
页数：7
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