3.8 Article

Taking the Temperature on Machine Perfusion

Journal

CURRENT TRANSPLANTATION REPORTS
Volume 8, Issue 3, Pages 241-249

Publisher

SPRINGERNATURE
DOI: 10.1007/s40472-021-00337-y

Keywords

Transplantation; Organ bioengineering; Organ perfusion; Viability assessment; Liver regeneration

Funding

  1. Massachusetts General Hospital Executive Committee on Research (ECOR)
  2. National Institutes of Health [R01DK096075]

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Advances in machine perfusion technology have significantly improved organ utilization, with ongoing exploration of various perfusion modalities. Recent studies have shown excellent outcomes with normothermic and hypothermic perfusion for liver preservation, and combination strategies also hold promise. Furthermore, research on machine perfusion with adjunct therapeutics is actively being pursued, with potential for rapid translation into clinical trials.
Purpose of Review Advances in machine perfusion technology have significantly improved organ utilization. However, consensus regarding the best dynamic preservation modality remains elusive. In this report, we evaluate recent results of clinical studies for different perfusion modalities and review new avenues of basic science aimed at organ rehabilitation. Recent Findings Randomized clinical trials of normothermic and hypothermic perfusion for liver preservation have demonstrated excellent patient and graft survival. Additional strategies that combine multiple preservation modalities show promise in maximizing utilization of severely injured grafts. Studies of machine perfusion with adjunct therapeutics for organ rehabilitation are being actively explored in the pre-clinical setting with potential for rapid translation into clinical trials. As machine perfusion becomes more widely incorporated into routine clinical use, graft utilization and transplant outcomes are likely to further improve. Logistics considerations that expand the use of this technology while minimizing costs will foster its broader adoption. Therapeutic strategies that aim to rehabilitate untransplantable grafts have the potential to greatly expand the pool of donor organs for transplantation, thereby easing the organ shortage.

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