Normothermic Machine Perfusion in pediatric liver transplantation: A survey of attitudes and barriers

Kadakia, Yash; MacConmara, Malcolm; Patel, Madhukar S.; Shah, Jigesh A.; Muniz, Lucia de Gregorio; Desai, Dev M.; Hanish, Steven I.; Vagefi, Parsia A.; Hwang, Christine

doi:10.1111/petr.14282

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…However, 4/9 partial livers that survived >7 days were LLSGs. The machine perfusion revolution has yet to be realised in the field of paediatrics 13 , perhaps due to technical challenges. Still, the adaptations and modifications achieved in this study pave the way for these advances.…”

Section: Discussionmentioning

confidence: 99%

Long-term ex situ normothermic perfusion of human split livers for more than 1 week

Lau

Dennis

et al. 2023

Nat Commun

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Current machine perfusion technology permits livers to be preserved ex situ for short periods to assess viability prior to transplant. Long-term normothermic perfusion of livers is an emerging field with tremendous potential for the assessment, recovery, and modification of organs. In this study, we aimed to develop a long-term model of ex situ perfusion including a surgical split and simultaneous perfusion of both partial organs. Human livers declined for transplantation were perfused using a red blood cell-based perfusate under normothermic conditions (36 °C) and then split and simultaneously perfused on separate machines. Ten human livers were split, resulting in 20 partial livers. The median ex situ viability was 125 h, and the median ex situ survival was 165 h. Long-term survival was demonstrated by lactate clearance, bile production, Factor-V production, and storage of adenosine triphosphate. Here, we report the long-term ex situ perfusion of human livers and demonstrate the ability to split and perfuse these organs using a standardised protocol.

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Section: Discussionmentioning

confidence: 99%

Long-term ex situ normothermic perfusion of human split livers for more than 1 week

Lau

Dennis

et al. 2023

Nat Commun

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show abstract

“…However, 4/9 partial grafts that survived > 7 days were LLSGs. The machine perfusion revolution has yet to be realised in the eld of paediatrics, 13 perhaps due to technical challenges. Still, the adaptations and modi cations achieved in this study pave the way for these advances.…”

Section: Discussionmentioning

confidence: 99%

Long-term ex-vivo normothermic perfusion of human split livers: a unique model to study new therapeutics and increase the number of available organs

Lau¹,

Ly²,

Dennis³

et al. 2023

Preprint

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Current perfusion technology only allows livers to be preserved ex-vivo for short periods. Long-term normothermic perfusion of livers is an emerging field with tremendous potential for the assessment, recovery, and modification of organs. In this study, we aimed develop a long-term model of ex-vivo perfusion including a surgical split and simultaneous perfusion of both partial grafts. Our long-term perfusion system included long-term oxygenators, a gas-mixer and a dialysis filter. Human livers declined for transplantation were perfused using a red-cell based perfusate under normothermic conditions (36°C) and then split and simultaneously perfused on separate machines. Ten human livers were split resulting in 20 partial grafts. The median ex-vivo survival was 165 hours (7 days). Long-term graft survival was demonstrated by lactate clearance, bile production, Factor-V production, and storage of adenosine triphosphate. The grafts that survived > 7 days demonstrated significantly higher bile production, Factor-V production, and hepatic arterial flow and significantly lower microvesicular steatosis. We report reliable long-term ex-vivo perfusion of human livers and demonstrate the ability to split and perfuse these organs using a reproducible protocol. This provides the opportunity for improved assessment of organs and could act as a model for the testing of therapeutics with a matched control.

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Normothermic Machine Perfusion in pediatric liver transplantation: A survey of attitudes and barriers

Cited by 2 publications

References 19 publications

Long-term ex situ normothermic perfusion of human split livers for more than 1 week

Long-term ex situ normothermic perfusion of human split livers for more than 1 week

Long-term ex-vivo normothermic perfusion of human split livers: a unique model to study new therapeutics and increase the number of available organs

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