TY - JOUR
T1 - Perfusion Pressures and Weight Loss During Normothermic Machine Perfusion of Human Donor Livers
AU - Lascaris, Bianca
AU - Bodewes, Silke B.
AU - Thorne, Adam M.
AU - van den Heuvel, Marius C.
AU - de Haas, Robbert J.
AU - Nijsten, Maarten W.N.
AU - de Meijer, Vincent E.
AU - Porte, Robert J.
N1 - Publisher Copyright: © 2024 The Author(s). Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.
PY - 2025
Y1 - 2025
N2 - Background: Normothermic machine perfusion (NMP) is increasingly used to preserve and assess donor livers prior to transplantation. Due to its success, it is expected that more centers will start using this technology. However, NMP may also cause adverse effects. Methods: In this retrospective, observational study, we investigated the effect of NMP pressures on donor liver weight, post-transplant outcomes, and hepatic perfusion characteristics. A total of 36 livers were transplanted after NMP. NMP perfusion pressure settings were lowered from a median (IQR) of 47 mmHg (42–54) to 34 mmHg (30–39) for the hepatic artery (HA), and from 8 mmHg (7–10) to 7 mmHg (6–8) for the portal vein (PV) to diminish potential edema formation inside the liver. Results: This change appeared to lead to a reduction of liver weight after NMP (−22 g to −143 g, p = 0.02), without affecting the PV flow velocity (35.5 to 48.0 cm/s, p = 0.54), or hepatocellular injury markers during NMP (AST 1511–1148 U/L, p = 0.44; ALT 318–849 U/L, p = 0.35), and post-transplantation outcomes. Changes in liver weight correlated significantly with the applied PV pressure during NMP (r = 0.52, p < 0.01) and the HA flow (r = 0.38, p < 0.05). Conclusion: NMP can lead to a reduction in liver weight, which might be masked by edema when high perfusion pressures are used. We encourage applying the lowest perfusion pressures possible to reach adequate flows and oxygen supply during liver NMP.
AB - Background: Normothermic machine perfusion (NMP) is increasingly used to preserve and assess donor livers prior to transplantation. Due to its success, it is expected that more centers will start using this technology. However, NMP may also cause adverse effects. Methods: In this retrospective, observational study, we investigated the effect of NMP pressures on donor liver weight, post-transplant outcomes, and hepatic perfusion characteristics. A total of 36 livers were transplanted after NMP. NMP perfusion pressure settings were lowered from a median (IQR) of 47 mmHg (42–54) to 34 mmHg (30–39) for the hepatic artery (HA), and from 8 mmHg (7–10) to 7 mmHg (6–8) for the portal vein (PV) to diminish potential edema formation inside the liver. Results: This change appeared to lead to a reduction of liver weight after NMP (−22 g to −143 g, p = 0.02), without affecting the PV flow velocity (35.5 to 48.0 cm/s, p = 0.54), or hepatocellular injury markers during NMP (AST 1511–1148 U/L, p = 0.44; ALT 318–849 U/L, p = 0.35), and post-transplantation outcomes. Changes in liver weight correlated significantly with the applied PV pressure during NMP (r = 0.52, p < 0.01) and the HA flow (r = 0.38, p < 0.05). Conclusion: NMP can lead to a reduction in liver weight, which might be masked by edema when high perfusion pressures are used. We encourage applying the lowest perfusion pressures possible to reach adequate flows and oxygen supply during liver NMP.
UR - http://www.scopus.com/inward/record.url?scp=85214098974&partnerID=8YFLogxK
U2 - 10.1111/aor.14939
DO - 10.1111/aor.14939
M3 - Article
C2 - 39737605
AN - SCOPUS:85214098974
SN - 0160-564X
JO - Artificial Organs
JF - Artificial Organs
ER -