“Hope and Hurdles” in Liver Machine Perfusion: A Review and Future Directions of Machine Perfusion in Liver Transplantation

Abstract

Purpose of Review A shortage of donor organs for liver transplant has led to innovations to improve organ preservation via machine perfusion. This review evaluates the latest literature on hypothermic and normothermic machine perfusion, as well as emerging efforts to combine perfusion modalities and logistical considerations. Recent Findings Randomized controlled trials utilizing both hypothermic and normothermic machine perfusion establish safety and benefit for organ utilization and outcomes for liver transplant. Data regarding combined perfusion strategies are emerging, with an emphasis on expanding the donor organ pool with extended criteria donors. Logistical considerations such as cost, allocation, policy development, and education will need to be considered to facilitate more widespread adoption. Summary Machine perfusion is an important innovation in liver transplant that improves outcomes. Future studies are needed for expanded applications and policy development is necessary for its implementation.