Liver transplantation is a highly successful treatment, but is severely limited by the shortage in donor organs. However, many potential donor organs cannot be used; this is because sub-optimal livers do not tolerate conventional cold storage and there is no reliable way to assess organ viability preoperatively. Normothermic machine perfusion maintains the liver in a physiological state, avoids cooling and allows recovery and functional testing. Here we show that, in a randomized trial with 220 liver transplantations, compared to conventional static cold storage, normothermic preservation is associated with a 50% lower level of graft injury, measured by hepatocellular enzyme release, despite a 50% lower rate of organ discard and a 54% longer mean preservation time. There was no significant difference in bile duct complications, graft survival or survival of the patient. If translated to clinical practice, these results would have a major impact on liver transplant outcomes and waiting list mortality.Normothermic machine perfusion of the liver improved early graft function, demonstrated by reduced peak serum aspartate transaminase levels and early allograft dysfunction rates, and improved organ utilization and preservation times, although no differences were seen in graft or patient survival.

中文翻译：

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肝移植常温保存的随机试验

肝移植是一种非常成功的治疗方法，但受到供体器官短缺的严重限制。然而，许多潜在的供体器官无法使用；这是因为次优肝脏不能耐受传统的冷藏，并且没有可靠的方法在术前评估器官活力。常温机器灌注将肝脏维持在生理状态，避免冷却并允许恢复和功能测试。在这里，我们表明，在一项包含 220 例肝移植的随机试验中，与传统的静态冷藏相比，常温保存与通过肝细胞酶释放测量的移植物损伤水平降低 50% 相关，尽管器官丢弃率降低了 50%平均保存时间延长 54%。胆管并发症无显着差异，移植物存活或患者的存活。如果转化为临床实践，这些结果将对肝移植结果和等候名单死亡率产生重大影响。肝脏的常温机器灌注改善了早期移植物功能，表现为血清天冬氨酸转氨酶峰值降低和早期同种异体移植物功能障碍率降低，并改善了器官使用和保存时间，尽管在移植物或患者存活率方面没有发现差异。