Association of perfusion characteristics and post-transplant liver function in ischemia-free liver transplantation.

It has been shown that normothermic machine perfusion (NMP), a novel preservation method, is able to assess and resuscitate liver grafts with risk factors. However, there is no consistent criteria for assessment of liver graft with NMP. Ischemia-free liver transplantation (IFLT) includes innovative surgical techniques and NMP, which can protect liver grafts from ischemia throughout organ procurement, preservation and implantation. In our center, 28 human livers from donation after brain death (DBD) were subjected to IFLT between July 2017 and October 2018. Correlation between post-transplant liver function tests with the perfusion parameters, blood gas analysis of perfusate and bile biochemistry were analyzed. During preservation phase, the vascular flow was stable and the lactate level decreased rapidly. The transaminase release in the perfusate was stably low, while the glucose level maintained a high level. The perfusate lactate and aspartate aminotransferase (AST) levels at one hour of perfusion were correlated with the post-transplant peak AST level. There were negative correlations between the portal vein/hepatic artery flow at the end of perfusion and the peak transaminase levels within 7 days post-transplantation. In conclusion, during IFLT, NMP is able to bridge the liver grafts from donors to recipients and can allow the assessment of liver function by perfusion characteristics.