Current drastic shortage of donor organs has led to acceptance of extended-criteria donor (ECD) livers for transplantation, despite higher risk of primary graft dysfunction.
Here we report the impact of normo- (30-37℃) and/or subnormothermic (20-25℃) machine perfusion (MP) preservation on the integrity of non-parenchymal cells of liver grafts in the model of isolated perfused rat liver (IPRL). Moreover, we investigated whether MP could resuscitate marginal fatty livers those should be discarded when preserved by the gold standard method, cold storage (CS).
Compared with CS, normothermic MP could maintain functional and morphological viability of not only parenchymal but also non-parenchymal cells, such as sinusoidal endothelial cells and stellate cells. Furthermore, subnormothermic MP resulted in significantly better preservation of sinusoidal microvasculature and hepatocellular mitochondria, both of which are characteristic disadvantages of steatotic liver grafts. Thus subnormothermic MP could prevent primary non function of 50-60% macro-steatotic livers, thereby providing a new possibility to expand the donor pools available.
