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Review | Open Access

The Interconnection Between the Liver and Other Organs: Insights for Hepatic Long–Term Normothermic Machine Perfusion

Ruilin Cai1,2,3, Zhiying Liu4, Zhiyin Feng5, Meiting Qin1,2,3, Jiahao Li1,2,3, Qiang Zhao1,2,3( ), Xiaoshun He1,2,3 ( )
Organ Transplant Center, The First Affiliated Hospital, Sun Yat‐sen University, Guangzhou, Guangdong, China
Guangdong Provincial Key Laboratory of Organ Medicine, Guangzhou, Guangdong, China
Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, Guangdong, China
Zhongshan School of Medicine, Sun Yat‐sen University, Guangzhou, Guangdong, China
Sun Yat‐sen University School of Medicine, Sun Yat‐sen University, Shenzhen, Guangdong, China

Ruilin Cai and Zhiying Liu contributed equally as first authors.

Show Author Information

Graphical Abstract

This paper reviews clinical and experimental studies, highlighting the impact of multiple organ absence on the long‐term survival of isolated livers during long–term normothermic machine perfusion(LNMP). It also proposes recommendations for establishing a more stable LNMP platform.

Abstract

Normothermic machine perfusion (NMP) is emerging as a promising technique for organ preservation, evaluation, and scientific research, offering the potential to enhance the viability and function of donor organs. To fully harness the benefits of NMP, sustained long–term NMP (LNMP) at 36℃ for periods exceeding 24 h is required. However, the development of stable LNMP devices is hindered by our limited understanding of ex vivo liver physiology. This review synthesizes insights from clinical and experimental studies to highlight the knowledge gaps associated with the impact of the absence of various organs or systems on isolated livers during ex vivo perfusion. Additionally, it discusses liver injuries and adverse events documented in published liver LNMP studies, elucidating their underlying mechanisms. By analyzing these findings, the paper proposes a series of recommendations to establish a more stable LNMP platform, aiming to optimize the outcomes of liver preservation and expand the applications of NMP in clinical practice and research.

Keywords

ischemia–reperfusion injuryliver transplantationlong–term normothermic machine perfusionorgan medicine

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Organ Medicine
Volume 1 Issue 1,
September 2024
Pages 6-20
DOI: 10.1002/orm2.8
Cite this article:
Cai R, Liu Z, Feng Z, et al. The Interconnection Between the Liver and Other Organs: Insights for Hepatic Long–Term Normothermic Machine Perfusion. Organ Medicine, 2024, 1(1): 6-20. https://doi.org/10.1002/orm2.8

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Received: 28 August 2024
Accepted: 04 September 2024
Published: 20 October 2024
© 2024 The Author(s).

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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