Toward the first application of machine perfusion for liver transplantation in Japan

Abstract

Background and Aim: The development of a machine perfusion (MP) device that can perform both normothermic perfusion (NMP) and hypothermic oxygenated machine perfusion (HOPE) more safely and for a longer period of time is demanded. We report our efforts to develop a MP. Methods: The developed MP device employed perfusion using hydraulic gradient. 1.Using a porcine model, grafts from donors after circulatory death (DCD), 1 hours after cardiac arrest and long-term 14 hours cold ischemic model of donation after brain death (DBD) were transplanted. DCD grafts were placed in a negative pressure sealed container to remove thrombus and to improve perfusion kinetics. Both models conducted 3 hours NMP (37 degree Celsius). 2. We developed a HOPE device. Results: In both DCD and DBD model, bile production and metabolic improvement, the survival for 3 days after transplant were confirmed. For developing HOPE device, pumpless perfusion with cold perfusate (10 degree Celsius) was supplied. Conclusion: We succeeded a MP device for both NMP and HOPE. We continue to improve and establish the MP device for liver transplantation in Japan with considering practical situation of organ donation in Japan.