Machine perfusion

Machine perfusion (MP) is an artificial perfusion technique often used for organ preservation to help facilitate organ transplantation. MP works by continuously pumping a specialized solution through donor organs, mimicking the body's natural blood flow while actively controlling temperature, oxygen levels, chemical composition, and mechanical stress within the organ. By maintaining organ viability outside the body for extended periods, machine perfusion addresses critical challenges in organ transplantation, such as limited preservation times.^[1]^[2]^[3]

Machine perfusion has various forms and can be categorised according to the temperature of the perfusate: cold (4 °C) and warm (37 °C).^[4] Machine perfusion has been applied to renal transplantation,^[5] liver transplantation^[6] and lung transplantation.^[7] It is an alternative to static cold storage (SCS).

^ Fujiyoshi, Masato; de Meijer, Vincent E.; Porte, Robert J. (2021-01-01), Orlando, Giuseppe; Keshavjee, Shaf (eds.), "Chapter 2 - Machine perfusion for donor organ repair: from vision to everyday clinical practice", Organ Repair and Regeneration, Academic Press, pp. 43–73, ISBN 978-0-12-819451-5, retrieved 2024-07-31
^ Jing, Lei; Yao, Leeann; Zhao, Michael; Peng, Li-ping; Liu, Mingyao (2018). "Organ preservation: from the past to the future". Acta Pharmacologica Sinica. 39 (5): 845–857. doi:10.1038/aps.2017.182. ISSN 1745-7254. PMC 5943901. PMID 29565040.
^ Qin, Guangqi; Jernryd, Victoria; Sjöberg, Trygve; Steen, Stig; Nilsson, Johan (2022-03-21). "Machine Perfusion for Human Heart Preservation: A Systematic Review". Transplant International. 35: 10258. doi:10.3389/ti.2022.10258. ISSN 0934-0874. PMC 8983812. PMID 35401041.
^ Kay, Mark D.; Hosgood, Sarah A.; Harper, Simon J.F.; Bagul, Atul; Waller, Helen L.; Nicholson, Michael L. (November 2011). "Normothermic Versus Hypothermic Ex Vivo Flush Using a Novel Phosphate-Free Preservation Solution (AQIX) in Porcine Kidneys". Journal of Surgical Research. 171 (1): 275–282. doi:10.1016/j.jss.2010.01.018. PMID 20421110.
^ Yong, Cissy; Hosgood, Sarah A.; Nicholson, Michael L. (June 2016). "Ex-vivo normothermic perfusion in renal transplantation: past, present and future". Current Opinion in Organ Transplantation. 21 (3): 301–307. doi:10.1097/MOT.0000000000000316. ISSN 1087-2418. PMID 27145197. S2CID 22627245.
^ Ceresa, Carlo D. L.; Nasralla, David; Coussios, Constantin C.; Friend, Peter J. (February 2018). "The case for normothermic machine perfusion in liver transplantation: Ceresa et al". Liver Transplantation. 24 (2): 269–275. doi:10.1002/lt.25000. PMID 29272051.
^ Cypel, Marcelo; Yeung, Jonathan C.; Liu, Mingyao; Anraku, Masaki; Chen, Fengshi; Karolak, Wojtek; Sato, Masaaki; Laratta, Jane; Azad, Sassan; Madonik, Mindy; Chow, Chung-Wai (2011-04-14). "Normothermic Ex Vivo Lung Perfusion in Clinical Lung Transplantation" (PDF). New England Journal of Medicine. 364 (15): 1431–1440. doi:10.1056/NEJMoa1014597. ISSN 0028-4793. PMID 21488765. S2CID 10576812. Archived from the original (PDF) on 2020-02-22.

[1] Fujiyoshi, Masato; de Meijer, Vincent E.; Porte, Robert J. (2021-01-01), Orlando, Giuseppe; Keshavjee, Shaf (eds.), "Chapter 2 - Machine perfusion for donor organ repair: from vision to everyday clinical practice", Organ Repair and Regeneration, Academic Press, pp. 43–73, ISBN 978-0-12-819451-5, retrieved 2024-07-31

[2] Jing, Lei; Yao, Leeann; Zhao, Michael; Peng, Li-ping; Liu, Mingyao (2018). "Organ preservation: from the past to the future". Acta Pharmacologica Sinica. 39 (5): 845–857. doi:10.1038/aps.2017.182. ISSN 1745-7254. PMC 5943901. PMID 29565040.

[3] Qin, Guangqi; Jernryd, Victoria; Sjöberg, Trygve; Steen, Stig; Nilsson, Johan (2022-03-21). "Machine Perfusion for Human Heart Preservation: A Systematic Review". Transplant International. 35: 10258. doi:10.3389/ti.2022.10258. ISSN 0934-0874. PMC 8983812. PMID 35401041.

[4] Kay, Mark D.; Hosgood, Sarah A.; Harper, Simon J.F.; Bagul, Atul; Waller, Helen L.; Nicholson, Michael L. (November 2011). "Normothermic Versus Hypothermic Ex Vivo Flush Using a Novel Phosphate-Free Preservation Solution (AQIX) in Porcine Kidneys". Journal of Surgical Research. 171 (1): 275–282. doi:10.1016/j.jss.2010.01.018. PMID 20421110.

[5] Yong, Cissy; Hosgood, Sarah A.; Nicholson, Michael L. (June 2016). "Ex-vivo normothermic perfusion in renal transplantation: past, present and future". Current Opinion in Organ Transplantation. 21 (3): 301–307. doi:10.1097/MOT.0000000000000316. ISSN 1087-2418. PMID 27145197. S2CID 22627245.

[6] Ceresa, Carlo D. L.; Nasralla, David; Coussios, Constantin C.; Friend, Peter J. (February 2018). "The case for normothermic machine perfusion in liver transplantation: Ceresa et al". Liver Transplantation. 24 (2): 269–275. doi:10.1002/lt.25000. PMID 29272051.

[7] Cypel, Marcelo; Yeung, Jonathan C.; Liu, Mingyao; Anraku, Masaki; Chen, Fengshi; Karolak, Wojtek; Sato, Masaaki; Laratta, Jane; Azad, Sassan; Madonik, Mindy; Chow, Chung-Wai (2011-04-14). "Normothermic Ex Vivo Lung Perfusion in Clinical Lung Transplantation" (PDF). New England Journal of Medicine. 364 (15): 1431–1440. doi:10.1056/NEJMoa1014597. ISSN 0028-4793. PMID 21488765. S2CID 10576812. Archived from the original (PDF) on 2020-02-22.

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