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Ex Vivo Normothermic Machine Perfusion

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Donation after Circulatory Death (DCD) Liver Transplantation

Abstract

Normothermic machine perfusion (NMP) involves perfusing organs ex vivo with normothermic oxygenated blood–based solutions that recreate the physiological environment, thereby tending to decrease the detrimental effects seen with standard cold storage (SCS). Several different NMP platforms exist that are in various stages of development. NMP has the potential to restore normal metabolic physiology, recondition marginal livers, and allow for the assessment of graft viability. The use of NMP for donation after circulatory death (DCD) liver grafts has been of particular interest, given the additional period of damaging warm ischemia these grafts are exposed to compared to donation after brain death (DBD) liver grafts. The present chapter describes the rationale for NMP, as well as providing a summary of pre-clinical and clinical studies that have investigated its application. The various platforms for NMP that have been utilized are also described.

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Author information

Authors and Affiliations

  1. Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA

    Daniele Pezzati & Cristiano Quintini

  2. Cleveland Clinic Liver Transplant Center, Department of General Surgery, Cleveland, OH, USA

    Qiang Liu

Authors
  1. Daniele Pezzati
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  2. Qiang Liu
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  3. Cristiano Quintini
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Corresponding author

Correspondence to Cristiano Quintini .

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Editors and Affiliations

  1. Department of Transplant, Mayo Clinic, Jacksonville, FL, USA

    Kristopher P. Croome

  2. Queen Elizabeth Hospital Birmingham, Birmingham, UK

    Paolo Muiesan

  3. Department of Transplant, Mayo Clinic, Jacksonville, FL, USA

    C. Burcin Taner

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Pezzati, D., Liu, Q., Quintini, C. (2020). Ex Vivo Normothermic Machine Perfusion. In: Croome, K., Muiesan, P., Taner, C. (eds) Donation after Circulatory Death (DCD) Liver Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-030-46470-7_15

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  • DOI: https://doi.org/10.1007/978-3-030-46470-7_15

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