Ex Vivo Liver Machine Perfusion: Comprehensive Review of Common Animal Models
Publication: Tissue Engineering Part B: Reviews
Volume 29, Issue Number 1
Abstract
The most common preservation technique for liver grafts is static cold storage. Due to the organ shortage for liver transplantation (LT), extended criteria donor (ECD) allografts are increasingly used—despite the higher risk of inferior outcome after transplantation. Ex vivo liver machine perfusion (MP) has been developed to improve the outcome of transplantation, especially with ECD grafts, and is currently under evaluation in clinical trials. We performed a literature search on PubMed and ISI Web of Science to assemble an overview of rodent and porcine animal models of ex vivo liver MP for transplantation, which is essential for the present and future development of clinical liver MP. Hypothermic, subnormothermic, and normothermic MP systems have been successfully used for rat and pig LT. In comparison with hypothermic systems, normothermic perfusion often incorporates a dialysis unit. Moreover, it enables metabolic assessment of liver grafts. Allografts experiencing warm ischemic time have a superior survival rate after MP compared with cold storage alone, irrespective of the temperature used for perfusion. Furthermore, ex vivo MP improves the outcome of regular and ECD liver grafts in animal models. Small and large animal models of ex vivo liver MP are available to foster the further development of this new technology.
Impact Statement
Ex vivo machine perfusion is an important part of current research in the field of liver transplantation. While evidence for improve storage is constantly rising, the development of future applications such as quality assessment and therapeutic interventions necessitates robust animal models. This review is intended to provide an overview of this technology in common large and small animal models and to give an outlook on future applications. Moreover, we describe developmental steps that can be followed by others, and which can help to decrease the number of animals used for experiments based on the replace, reduce, refine concept.
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Information & Authors
Information
Published In
Tissue Engineering Part B: Reviews
Volume 29 • Issue Number 1 • February 2023
Pages: 10 - 27
PubMed: 35848526
Copyright
Copyright 2023, Mary Ann Liebert, Inc., publishers.
History
Published online: 7 February 2023
Published in print: February 2023
Published ahead of print: 21 September 2022
Published ahead of production: 17 July 2022
Accepted: 17 May 2022
Received: 28 January 2022
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Authors
Authors' Contributions
Conception and design of study: V.M., J.M.G.V.G., G.L., and N.R. Acquisition of data: V.M., J.M.G.V.G., S.M., J.M., F.S., K.K., and C.E. Analysis and interpretation of data: V.M., J.M.G.V.G., S.M., J.M., F.S., K.K., and C.E. Drafting of the article: V.M., J.M.G.V.G., G.L., J.P., I.M.S., and N.R. Revision of the article: V.M., J.M.G.V.G., G.L., F.T., M.S., J.P., I.M.S., and N.R.
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The authors declare no financial or competing interests.
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No funding was received for this article.
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