A breakthrough in the field of liver transplantation has been made with the introduction of machine perfusion techniques. These innovative methods offer hope for addressing the shortage of liver grafts and reducing complications post-transplantation. Different types of machine perfusion, such as hypothermic and normothermic perfusion, play a critical role in preserving and improving the quality of donor livers, thereby increasing the number of viable grafts available for transplantation. Recent research and successful case studies have demonstrated the effectiveness of these techniques in enhancing liver transplantation outcomes.
One notable development is the use of prolonged dual hypothermic oxygenated machine perfusion (DHOPE) to extend the preservation time of human donor livers to 20 hours without adverse effects. This breakthrough opens up opportunities for improved logistical efficiency, reduced operating times at night, enhanced performance, and training opportunities for transplant teams. The Universitair Medisch Centrum Groningen (UMCG) has reported successful transplantation with longer preservation of donor livers using a new perfusion machine, leading to a shift in transplant scheduling to daytime and shorter average operation times. Additionally, advancements in targeted therapy and checkpoint inhibitors for advanced liver cancer are showing promising results, while studies comparing living and deceased donor liver transplants are revealing potential benefits for patient survival rates.
However, extended criteria donor grafts in liver transplantation come with an increased risk of ischemic reperfusion injury. As a result, there is a growing need for innovative approaches that allow for extended preservation times, organ evaluation, and treatment. Researchers are scrutinizing existing strategies for liver preservation and exploring new developments to tackle the challenges associated with effective organ preservation and optimization.
In conclusion, machine perfusion techniques have the potential to revolutionize liver transplantation, offering solutions to the shortage of liver grafts and improving patient outcomes. These techniques represent a new era in the field, with the promise of increasing the number of viable organs for transplantation and paving the way for enhanced success rates.