Marginal grafts, such as fatty livers, grafts from older donors, or livers retrieved after cardiac death (DCD) tolerate conventional, cold static storage only poorly. We developed a novel model of subnormothermic ex vivo liver perfusion for preservation, assessment, and repair of marginal liver grafts prior to transplantation.
Total time
~4–6 hours per liver graft (retrieval through perfusion assessment)
Steps
1
Perform donation after cardiac death liver retrieval
Execute surgical retrieval of liver grafts from donors after cardiac death, including cessation of circulation protocols and organ procurement procedures.
▶ 01:12
2
Setup and initiate ex vivo liver perfusion
Assemble the subnormothermic perfusion apparatus, connect the liver graft, prime the system with perfusate, and establish normothermic (37°C) recirculating perfusion conditions.
▶ 02:32
3
Analyze graft function and viability during perfusion
Monitor perfusate parameters, lactate clearance, bile output, and organ appearance to assess marginal graft quality and repair efficacy in real-time.
▶ 07:33
4
Conclude perfusion and document graft assessment results
Terminate perfusion, document final graft condition, and prepare liver for transplantation or further analysis.
▶ 09:02