An Opportunity to Significantly Decrease Liver Wait‐List Death

Reply to ‘Hypothermic machine perfusion before viability testing of previously discarded human livers’

“…organs with the greatest potential for future expansion, on the global scale this remains a niche area as >90% of liver transplants in the Western world are currently performed with livers donated after brain death (DBD) 12,15,18 . As a result, a large majority of livers are underutilised due to steatosis or logistical reasons (e.g., suboptimal livers that might be usable, but the excessive projected cold ischaemic time precludes their use).…”

“…The VITTAL study linked primary endpoints of liver recovery rate and the 90-day graft survival. Worldwide, the risks of dying on the waiting list are significantly higher than the mortality after transplantation, and the organ utilisation parameters were used as proxy measures for access to the transplant treatment 12,13 . The inclusion of suboptimal livers in machine perfusion trials has been widely accepted by the transplant community, as these organs benefit most from the use of this novel technology 14,15 .…”