"resuscitation" of marginal liver allografts for transplantation with machine perfusion technology

Jay A. Graham, James V. Guarrera

Research output: Contribution to journalComment/debatepeer-review

84 Scopus citations


As the rate of medically suitable donors remains relatively static worldwide, clinicians have looked to novel methods to meet the ever-growing demand of the liver transplant waiting lists worldwide. Accordingly, the transplant community has explored many strategies to offset this deficit. Advances in technology that target the ex vivo "preservation" period may help increase the donor pool by augmenting the utilization and improving the outcomes of marginal livers. Novel ex vivo techniques such as hypothermic, normothermic, and subnormothermic machine perfusion may be useful to "resuscitate" marginal organs by reducing ischemia/reperfusion injury. Moreover, other preservation techniques such as oxygen persufflation are explored as they may also have a role in improving function of "marginal" liver allografts. Currently, marginal livers are frequently discarded or can relegate the patient to early allograft dysfunction and primary non-function. Bench to bedside advances are rapidly emerging and hold promise for expanding liver transplantation access and improving outcomes.

Original languageEnglish (US)
Pages (from-to)418-431
Number of pages14
JournalJournal of Hepatology
Issue number2
StatePublished - Aug 2014
Externally publishedYes


  • Extended criteria donor
  • Hypothermic
  • Liver
  • Machine preservation
  • Marginal liver
  • Normothermic
  • Organ preservation
  • Perfusion
  • Subnormothermic
  • Transplantation

ASJC Scopus subject areas

  • Hepatology


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