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  • Perspective
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Machine perfusion of the liver: applications in transplantation and beyond

Abstract

The shortage of donor livers considered suitable for transplantation has driven the development of novel methods for organ preservation and reconditioning. Machine perfusion techniques can improve the quality of marginal livers, extend the time for which they can be preserved and enable an objective assessment of their quality and viability. These benefits can help avoid the needless wastage of organs based on hypothetical concerns regarding quality. As machine perfusion techniques are gaining traction in clinical practice, attention has now shifted to their potential applications beyond transplantation. As well as providing an update on the current status of machine perfusion in clinical practice, this Perspective discusses how this technology is being used as a tool for therapeutic interventions including defatting of steatotic livers, immunomodulation and gene therapies.

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Fig. 1: Liver preservation.

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All authors researched data for the article, contributed to discussion of content, wrote the article and reviewed and/or edited the manuscript before submission.

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Correspondence to David Nasralla.

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P.J.F. is co-founder and Chief Medical Officer of OrganOx Ltd, a spin-out company from the University of Oxford that develops normothermic organ perfusion technology. C.D.L.C. has historically received income from OrganOx Ltd. for teaching and training and for carrying out normothermic preservations after normal working hours. The remaining authors declare no competing interests.

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Ceresa, C.D.L., Nasralla, D., Pollok, JM. et al. Machine perfusion of the liver: applications in transplantation and beyond. Nat Rev Gastroenterol Hepatol 19, 199–209 (2022). https://doi.org/10.1038/s41575-021-00557-8

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