UMMS Affiliation

Department of Surgery, Transplant Division

Publication Date


Document Type



Gastroenterology | Hepatology | Surgery | Surgical Procedures, Operative


The realm of extended criteria liver transplantation created the 'adjacent possible' for dynamic organ preservation. Machine perfusion of the liver greatly expanded donor organ preservation possibilities, reaching before unattainable goals, including the mitigation of ischemia-reperfusion injury, viability assessment, and organ reconditioning prior to transplantation. However, current scientific evidence lacks uniformity between studies, perfusion protocols, and acceptance criteria. Construction of collaborative research networks for sharing knowledge should, therefore, enable the development of high-level evidence and guidelines for machine perfusion utilization, including donor acceptance criteria. Finally, this approach shall guarantee conditions for further progress to occur.


Clinical trials, Extended criteria donors, Liver preservation, Liver transplantation, Machine perfusion of the liver, Organ donation

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Copyright © The Author(s) 2021. This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

DOI of Published Version



Boteon YL, Martins PN, Muiesan P, Schlegel A. Machine perfusion of the liver: Putting the puzzle pieces together. World J Gastroenterol. 2021 Sep 14;27(34):5727-5736. doi: 10.3748/wjg.v27.i34.5727. PMID: 34629797; PMCID: PMC8473597. Link to article on publisher's site

Journal/Book/Conference Title

World journal of gastroenterology

Related Resources

Link to Article in PubMed

PubMed ID


Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License