Prolonged preservation of donor livers: the benefits of hypothermic machine perfusion

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    A major challenge in liver transplantation lies in the short time a donor liver can be kept viable outside the body. Preservation by traditional static cold storage is a simple and effective approach to preserve good quality donor livers, but is associated with a number of limitations, including inevitable ischemia-reperfusion injury and a limited preservation time. Machine perfusion as a novel method of organ preservation facilitates the preservation and optimization of donor organs at variable temperatures. It has been shown that a brief period (2 hours) of hypothermic (4-12°C) oxygenated machine perfusion (HOPE) protects livers against ischemia-reperfusion injury. In this thesis, we investigated whether HOPE could also be used to prolong preservation time. In a preclinical study, we show successful preservation of porcine donor livers up to 24 hours with equivalent hepatobiliary function and injury after reperfusion compared to livers preserved with 2 hours HOPE. The results of a multicenter, retrospective, cohort study show that outcomes after liver transplantation are not compromised when livers are preserved by prolonged (≥4 hours) HOPE with total preservation times up to 21 hours. Finally, a prospective clinical trial was initiated to investigate safety and feasibility of prolonged HOPE in liver transplantation (DHOPE-PRO trial). If the results of this trial confirm prolonged preservation of donor livers by HOPE is safe and feasible, this may have important implications for everyday transplant logistics.
    Originele taal-2English
    KwalificatieDoctor of Philosophy
    Toekennende instantie
    • Rijksuniversiteit Groningen
    Begeleider(s)/adviseur
    • Porte, Robert, Supervisor
    • Lisman, Ton, Supervisor
    • de Meijer, Vincent, Co-supervisor
    • Martins, Paulo N., Co-supervisor, Externe Persoon
    Datum van toekenning16-mei-2022
    Plaats van publicatie[Groningen]
    Uitgever
    DOI's
    StatusPublished - 2022

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