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  • Review Article
  • Published:

Advances in the management of the explanted donor liver

Nature Reviews Gastroenterology & Hepatology volume 11, pages 489–496 (2014)Cite this article

Subjects

Key Points

  • Successful organ yield depends on intrinsic donor characteristics as well as clinical interventions on the potential donor and the explanted liver

  • With low costs and simple technical and logistical requirements, static cold storage is still the standard method of preservation in liver transplantation, rather than machine perfusion

  • Dynamic storage systems for liver preservation have not yet realized their potential but might have tremendous consequences for transplant outcome and surgical routines

  • With restrictive donor selection, outcomes of split-liver transplantation can be comparable to full-size liver transplantation and help to expand the donor pool

Abstract

Liver transplantation is the best therapy in end-stage liver disease. Donor organ shortage and efforts to expand the donor organ pool are permanent issues given that advances in perioperative management and immunosuppressive therapy have brought the procedure into widespread clinical use. The management of organ procurement, including donor preconditioning and adequate organ storage, has a key role in transplantation. However, the organ procurement process can differ substantially between transplant centres, depending on local and national preferences. Advances in the field have come from experimental and clinical research on dynamic storage systems, such as machine perfusion devices, as an alternative to static cold storage. Determination of the clinical significance of these new systems is a topic worthy of future investigations.

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Figure 1: Schematic representation of a persufflated liver during cold storage on ice.

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Authors and Affiliations

  1. Department of General, Visceral, and Transplant Surgery, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany

    Maxim Nebrig, Peter Neuhaus & Andreas Pascher

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  1. Maxim Nebrig
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  2. Peter Neuhaus
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M.N. and A.P. contributed to all aspects of this manuscript. P.N. reviewed/edited the manuscript before submission.

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Correspondence to Andreas Pascher.

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Nebrig, M., Neuhaus, P. & Pascher, A. Advances in the management of the explanted donor liver. Nat Rev Gastroenterol Hepatol 11, 489–496 (2014). https://doi.org/10.1038/nrgastro.2014.58

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