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The number of donor organs suitable for liver transplantation is restricted by cold preservation and ischemia-reperfusion injury. We present the first patients transplanted using a normothermic machine perfusion (NMP) device that transports and stores an organ in a fully functioning state at 37°C. In this Phase 1 trial, organs were retrieved using standard techniques, attached to the perfusion device at the donor hospital, and transported to the implanting center in a functioning state. NMP livers were matched 1:2 to cold-stored livers. Twenty patients underwent liver transplantation after NMP. Median NMP time was 9.3 (3.5-18.5) h versus median cold ischaemia time of 8.9 (4.2-11.4) h. Thirty-day graft survival was similar (100% NMP vs. 97.5% control, p = 1.00). Median peak aspartate aminotransferase in the first 7 days was significantly lower in the NMP group (417 IU [84-4681]) versus (902 IU [218-8786], p = 0.03). This first report of liver transplantation using NMP-preserved livers demonstrates the safety and feasibility of using this technology from retrieval to transplantation, including transportation. NMP may be valuable in increasing the number of donor livers and improving the function of transplantable organs.

Original publication

DOI

10.1111/ajt.13708

Type

Journal article

Journal

Am J Transplant

Volume

16

Pages

1779 - 1787

Keywords

Adult, Aged, Aged, 80 and over, Case-Control Studies, Cold Ischemia, Feasibility Studies, Female, Graft Survival, Humans, Liver Diseases, Liver Transplantation, Male, Middle Aged, Organ Preservation, Perfusion, Tissue Donors, Tissue and Organ Harvesting, Warm Ischemia, Young Adult