Transplantation of Discarded Livers Following Viability Testing with Normothermic Machine Perfusion

Overview

Journal Nat Commun

Specialty Biology

Date 2020 Jun 18

PMID 32546694

Citations 134

Authors

Hynek Mergental

Richard W Laing

Amanda J Kirkham

M Thamara P R Perera

Yuri L Boteon

Joseph Attard

Darren Barton

Stuart Curbishley

Manpreet Wilkhu

Desley A H Neil

Stefan G Hubscher

Paolo Muiesan

John R Isaac

Keith J Roberts

Manuel Abradelo

Andrea Schlegel

James Ferguson

Hentie Cilliers

Julian Bion

David H Adams

Chris Morris

Peter J Friend

Christina Yap

Simon C Afford

Darius F Mirza

Affiliations

Soon will be listed here.

Abstract

There is a limited access to liver transplantation, however, many organs are discarded based on subjective assessment only. Here we report the VITTAL clinical trial (ClinicalTrials.gov number NCT02740608) outcomes, using normothermic machine perfusion (NMP) to objectively assess livers discarded by all UK centres meeting specific high-risk criteria. Thirty-one livers were enroled and assessed by viability criteria based on the lactate clearance to levels ≤2.5 mmol/L within 4 h. The viability was achieved by 22 (71%) organs, that were transplanted after a median preservation time of 18 h, with 100% 90-day survival. During the median follow up of 542 days, 4 (18%) patients developed biliary strictures requiring re-transplantation. This trial demonstrates that viability testing with NMP is feasible and in this study enabled successful transplantation of 71% of discarded livers, with 100% 90-day patient and graft survival; it does not seem to prevent non-anastomotic biliary strictures in livers donated after circulatory death with prolonged warm ischaemia.

Citing Articles

Transplantation of Patients with Hepatocellular Carcinoma Through Increased Utilization of Machine Perfusion Technology.

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PMID: 40078822 PMC: 11896107. DOI: 10.1097/TXD.0000000000001777.

'Back-to-base' combined hypothermic and normothermic machine perfusion of human donor livers.

van Leeuwen O, Lantinga V, Lascaris B, Thorne A, Bodewes S, Nijsten M Nat Protoc. 2025; .

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Perspectives and Tools in Liver Graft Assessment: A Transformative Era in Liver Transplantation.

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AAV capsid prioritization in normal and steatotic human livers maintained by machine perfusion.

Kim J, Kurial S, Choksi P, Nunez M, Lunow-Luke T, Bartel J Nat Biotechnol. 2025; .

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Real-Time Biomarkers of Liver Graft Quality in Hypothermic Oxygenated Machine Perfusion.

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