Ex situ machine perfusion of donor livers prior to liver transplantation

Transplantation surgery

Prof. dr. R.J. Porte
Dr. V.E. de Meijer
dr. O.B. van Leeuwen

Nature of the research:
Basic, translational and clinical

Fields of study:
surgery gastroenterology

Background / introduction
In the Netherlands, over 30-40% of available donor livers is currently not used for transplantation, because the risk of post-transplant complications is considered too high. Unfortunately, mortality on the waiting list for a donor organ is still present. The rates of complications after liver transplantation are largely related to the amount of ischemia-reperfusion injury that a donor organ experiences during procurement, preservation and implantation in the recipient.

Over the last years in the University Medical Center Groningen, pioneering research has been performed on the use of ex situ machine perfusion of donor livers. This technique can result in a reduction of ischemia-reperfusion injury of donor livers, and donor livers can be tested prior to transplantation. Currently, large amounts of basic, translational and clinical research is performed using ex situ machine perfusion of donor livers to further improve this technique and reduce the number of discarded donor livers.
Research question / problem definition
How can we improve the quality of donor livers that are considered not suitable for transplantation?
- Experiments with porcine livers on the additional benefits of certain medication supplements during ex situ machine perfusion

- potential participation in clinical machine perfusion procedures

- potential participation in ongoing experimental (porcine) machine perfusion procedures

- potential participation in analyzing samples collected during machine perfusion of donor livers
- van Rijn R, Schurink IJ, de Vries Y, et al. Hypothermic Machine Perfusion in Liver Transplantation—A Randomized Trial. N Engl J Med. 2021;384:1391-1401.

- van Leeuwen OB, de Vries Y, Fujiyoshi M, et al. Transplantation of High-risk Donor Livers After Ex Situ Resuscitation and Assessment Using Combined Hypo- and Normothermic Machine Perfusion: A Prospective Clinical Trial. Ann Surg. 2019;270:906-914
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