Normothermic Machine Perfusion in Liver Transplantation – Seven Year Experience at a Single North American Centre
1Department of Surgery, University of Alberta, Edmonton, AB, Canada, 2Alberta Health Services, Edmonton, AB, Canada
Meeting: 2022 American Transplant Congress
Abstract number: 133
Keywords: Liver grafts, Liver transplantation, Machine preservation, Perfusion
Topic: Clinical Science » Liver » 57 - Liver: Surgery Innovative Techniques*
Session Information
Session Name: Surgery innovative Techniques Including Living Donor
Session Type: Rapid Fire Oral Abstract
Date: Sunday, June 5, 2022
Session Time: 5:30pm-7:00pm
Presentation Time: 5:50pm-6:00pm
Location: Hynes Room 313
*Purpose: Machine perfusion for preservation of liver grafts before transplantation has risen in prominence over the past decade. Normothermic machine perfusion (NMP), in particular, has been bolstered by a multicentre, randomized control trial published in 2018 by Nasralla et al., which showed decreased graft injury, despite a greater than 50% increase in graft utilization. The liver transplant program at the University of Alberta Hospital in Edmonton, Canada was one of the first North American centres to adopt this technology. Herein, we describe the 7-year outcomes from our centre, part of an open-label, non-randomized clinical trial (NCT03089840).
*Methods: Between January 1, 2015 and December 1, 2021, 78 livers were transplanted after undergoing NMP on the OrganOx metra® device. Clinical outcomes from 316 liver transplanted following static cold storage (SCS) only during the same time period, who were not part of the trial, were also collected for comparison.
*Results: Perfused grafts had an average NMP time of 538±24 minutes and an average SCS time of 316±12 minutes, which was not significantly different from the cold storage time of 316 livers transplanted after only SCS (302±9 minutes) during the same period (p=0.441). Despite significantly prolonged overall preservation time (p<0.0001), we found no difference in the majority of early outcomes, including early allograft dysfunction and 1 year patient survival (p=0.990 and 0.7317, respectively), and even a trend towards improved 30-day graft survival (p=0.05).
*Conclusions: Our extensive, early experience with NMP technology confirms the major finding of the larger clinical trial by Nasralla et al. that NMP is a safe means of preserving liver allografts for extended periods of time. Confirming safety and efficacy of this technology in the North American setting is an essential step in the development of protocols to assess and optimize liver grafts, with the ultimate goal of improving organ utilization and clinical outcomes for liver transplant recipients.
To cite this abstract in AMA style:
Hefler J, Izuierdo DL, Meeberg G, Bral M, Anderson B, Dajani K, Kneteman N, Bigam DL, Shapiro A. Normothermic Machine Perfusion in Liver Transplantation – Seven Year Experience at a Single North American Centre [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/normothermic-machine-perfusion-in-liver-transplantation-seven-year-experience-at-a-single-north-american-centre/. Accessed May 18, 2025.« Back to 2022 American Transplant Congress