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. 2025 Mar;49(3):431-440.
doi: 10.1111/aor.14905. Epub 2024 Nov 23.

Normothermic machine perfusion of explanted livers: Exploratory study of an alternative translational model for end-stage liver disease

Rachel Todd  1   2 , L Leonie van Leeuwen  1 , Matthew Holzner  1 , Leona Kim-Schluger  1 , Maria Isabel Fiel  3 , Daniel Puleston  2   4   5 , Sander S Florman  1 , M Zeeshan Akhtar  1   2   4
Affiliations

Normothermic machine perfusion of explanted livers: Exploratory study of an alternative translational model for end-stage liver disease

Rachel Todd et al. Artif Organs. 2025 Mar.

Abstract

Background: Normothermic machine perfusion (NMP) is a technique for donor liver preservation and assessment in transplantation. NMP has gained momentum recently by enabling safer use of higher risk organs via organ viability assessment. It also offers a platform for investigating ex vivo organ biology.

Methods: In this exploratory study, we completed a complex vascular reconstruction of explanted, diseased livers from patients undergoing transplantation and then perfused them normothermically on a closed perfusion circuit. We compared these livers to non-diseased donor livers via perfusate samples collected during perfusion.

Results: Five hepatectomized grafts and eight donor livers were perfused for 1 h or longer. Four hepatectomized livers cleared lactate, and all consumed glucose; all control livers cleared lactate, and seven utilized glucose. Significantly higher portal vein flows were achieved in the control group.

Conclusions: Our findings illustrate the feasibility of using closed-circuit NMP as a platform to study hepatectomized organs, which could reshape the research landscape in mechanisms of disease and applied therapeutics for patients with end-stage liver disease.

Keywords: hepatectomy; liver cirrhosis; liver diseases physiopathology; organ preservation.

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