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Liver transplantation is a highly successful treatment, but is severely limited by the shortage in donor organs. However, many potential donor organs cannot be used; this is because sub-optimal livers do not tolerate conventional cold storage and there is no reliable way to assess organ viability preoperatively. Normothermic machine perfusion maintains the liver in a physiological state, avoids cooling and allows recovery and functional testing. Here we show that, in a randomized trial with 220 liver transplantations, compared to conventional static cold storage, normothermic preservation is associated with a 50% lower level of graft injury, measured by hepatocellular enzyme release, despite a 50% lower rate of organ discard and a 54% longer mean preservation time. There was no significant difference in bile duct complications, graft survival or survival of the patient. If translated to clinical practice, these results would have a major impact on liver transplant outcomes and waiting list mortality.

Original publication

DOI

10.1038/s41586-018-0047-9

Type

Journal article

Journal

Nature

Publication Date

05/2018

Volume

557

Pages

50 - 56

Addresses

Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK. david.nasralla@nds.ox.ac.uk.

Keywords

Consortium for Organ Preservation in Europe