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Machine Perfusion of Organs

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Technological Advances in Organ Transplantation

Abstract

Transplant organ supplies are insufficient to meet the demands, resulting in prolonged patient wait times and waitlist mortality. Offering improved organ preservation, assessment, and resuscitation, machine perfusion of organs can enable the use of marginal organs, thereby expanding the donor pool. The technology is based on the common principle of continuous provision of oxygen and nutrients. Perfusion settings and components vary widely in terms of pump pulsatility, temperature control, oxygen provision, oncotic agents, and pharmacologic supplementation. While this technology was first pioneered in the 1960s, it has seen a recent resurgence. Hypothermic renal perfusion is the most clinically advanced area of perfusion and a source of continued innovation. Liver, heart, and lung perfusion techniques have been introduced into the clinical realm as safe alternatives, and evidence demonstrating clinical efficacy and superiority is accumulating. Machine perfusion of the pancreas and small intestine is being explored predominantly in preclinical models. Machine perfusion of limbs offers improved opportunities for limb transplantation and autologous replantation. Machine perfusion is a promising option to salvage function in marginal organ grafts and may enable prediction of organ function or dysfunction after transplantation.

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Authors and Affiliations

  1. Cleveland Clinic Transplant Center, Cleveland, OH, USA

    Matthew F. Blum, Qiang Liu, Basem Soliman, Toshihiro Okamoto, Bahar Bassiri-Gharb, Teresa Diago Uso, Laura D. Buccini & Cristiano Quintini

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Correspondence to Cristiano Quintini .

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    Satish N. Nadig

  2. Northwestern University, Chicago, Illinois, USA

    Jason A. Wertheim

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Blum, M.F. et al. (2017). Machine Perfusion of Organs. In: Nadig, S., Wertheim, J. (eds) Technological Advances in Organ Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-62142-5_2

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