Multipronged strategy of purposeful use of organs from non-heart beating donors

current status and future aspects of machine perfusion preservation in liver transplantation

Abstract

The use of expanded criteria donor (ECD) and donation after circulatory death (DCD) donor are one of important way of resolution for the critical shortage of diseased donor graft. However, the ischemic damage of these grafts jeopardizes organ viability during cold storage. Simple cold storage is the most widely used form of preservation in clinical practice even for these marginal grafts. However, it is questionable whether this method is able to prevent from deterioration of margiinal organ quality. Although, the fact that hypothermic machine perfusion might be superior to static cold preservation in reducing the high incident of delayed graft function, marginal grafts are exposed to warm and additional hypothermia induced damage. This review describes concepts and development by introducing new preservation technology of current status of machine perfusion preservation for marginal graft. The beneficial effects of normothermic machine perfusion as a new perspective preservation for DCD grafts also are introduced. Recently, beneficial effects of erwarming machine preservation for DCD liver graft has been reported. The development of novel preservation technology and science contribute to recovery from severe ischemic damage in marginal donor era.