Functional human liver preservation and recovery by means of subnormothermic machine perfusion.
Bote G Bruinsma, James H Avruch, Pepijn D Weeder, Gautham V Sridharan, Basak E Uygun, Negin G Karimian, Robert J Porte, James F Markmann, Heidi Yeh, Korkut Uygun
Author Information
Bote G Bruinsma: Center for Engineering in Medicine, Dept. of Surgery, Massachusetts General Hospital, Harvard Medical School.
James H Avruch: Transplant Center, Dept. of Surgery, Massachusetts General Hospital, Harvard Medical School.
Pepijn D Weeder: Center for Engineering in Medicine, Dept. of Surgery, Massachusetts General Hospital, Harvard Medical School.
Gautham V Sridharan: Center for Engineering in Medicine, Dept. of Surgery, Massachusetts General Hospital, Harvard Medical School.
Basak E Uygun: Center for Engineering in Medicine, Dept. of Surgery, Massachusetts General Hospital, Harvard Medical School.
Negin G Karimian: Center for Engineering in Medicine, Dept. of Surgery, Massachusetts General Hospital, Harvard Medical School.
Robert J Porte: Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center Groningen, University of Groningen.
James F Markmann: Transplant Center, Dept. of Surgery, Massachusetts General Hospital, Harvard Medical School.
Heidi Yeh: Transplant Center, Dept. of Surgery, Massachusetts General Hospital, Harvard Medical School; hyeh@partners.org.
Korkut Uygun: Center for Engineering in Medicine, Dept. of Surgery, Massachusetts General Hospital, Harvard Medical School; korkut.uygun@gmail.com.
There is currently a severe shortage of liver grafts available for transplantation. Novel organ preservation techniques are needed to expand the pool of donor livers. Machine perfusion of donor liver grafts is an alternative to traditional cold storage of livers and holds much promise as a modality to expand the donor organ pool. We have recently described the potential benefit of subnormothermic machine perfusion of human livers. Machine perfused livers showed improving function and restoration of tissue ATP levels. Additionally, machine perfusion of liver grafts at subnormothermic temperatures allows for objective assessment of the functionality and suitability of a liver for transplantation. In these ways a great many livers that were previously discarded due to their suboptimal quality can be rescued via the restorative effects of machine perfusion and utilized for transplantation. Here we describe this technique of subnormothermic machine perfusion in detail. Human liver grafts allocated for research are perfused via the hepatic artery and portal vein with an acellular oxygenated perfusate at 21 °C.
