Split-Liver Ex Situ Machine Perfusion: A Novel Technique for Studying Organ Preservation and Therapeutic Interventions

Viola Huang, Negin Karimian, Danielle Detelich, Siavash Raigani, Sharon Geerts, Irene Beijert, Fermin M. Fontan, Mohamed M. Aburawi, Sinan Ozer, Peony Banik, Florence Lin, Murat Karabacak, Ehab O. A. Hafiz, Robert J. Porte, Korkut Uygun, James F. Markmann, Heidi Yeh*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Ex situ machine perfusion is a promising technology to help improve organ viability prior to transplantation. However, preclinical studies using discarded human livers to evaluate therapeutic interventions and optimize perfusion conditions are limited by significant graft heterogeneity. In order to improve the efficacy and reproducibility of future studies, a split-liver perfusion model was developed to allow simultaneous perfusion of left and right lobes, allowing one lobe to serve as a control for the other. Eleven discarded livers were surgically split, and both lobes perfused simultaneously on separate perfusion devices for 3 h at subnormothermic temperatures. Lobar perfusion parameters were also compared with whole livers undergoing perfusion. Similar to whole-liver perfusions, each lobe in the split-liver model exhibited a progressive decrease in arterial resistance and lactate levels throughout perfusion, which were not significantly different between right and left lobes. Split liver lobes also demonstrated comparable energy charge ratios. Ex situ split-liver perfusion is a novel experimental model that allows each graft to act as its own control. This model is particularly well suited for preclinical studies by avoiding the need for large numbers of enrolled livers necessary due to the heterogenous nature of discarded human liver research.

Original languageEnglish
Article number269
Number of pages11
JournalJournal of Clinical Medicine
Issue number1
Publication statusPublished - 18-Jan-2020


  • machine perfusion
  • liver transplant
  • liver perfusion
  • split liver
  • ex situ perfusion
  • subnormothermic
  • normothermic
  • energy charge

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