Implementing an innovated preservation technology: The American Society of Transplant Surgeons' (ASTS) Standards Committee White Paper on Ex Situ Liver Machine Perfusion

UMMS Affiliation

Department of Surgery, Division of Organ Transplantation

Publication Date


Document Type



Analytical, Diagnostic and Therapeutic Techniques and Equipment | Health Services Administration | Hepatology | Surgery


The pervasive shortage of deceased donor liver allografts contributes to significant waitlist mortality despite efforts to increase organ donation. Ex vivo liver perfusion appears to enhance preservation of donor organs, extending viability and potentially evaluating function in organs previously considered too high risk for transplant. These devices pose novel challenges for organ allocation, safety, training, and finances. This white paper describes the American Society of Transplant Surgeons' belief that organ preservation technology is a vital advance, but its use should not change fundamental aspects of organ allocation. Additional data elements need to be collected, made available for organ assessment by transplant professionals to allow determination of organ suitability in the case of reallocation and incorporated into risk adjustment methodology. Finally, further work is needed to determine the optimal strategy for management and oversight of perfused organs prior to transplantation. Transplant Surgeons.


clinical research/practice, editorial/personal viewpoint, liver transplantation/hepatology, organ perfusion and preservation, organ procurement, organ procurement and allocation, organ procurement organization, risk assessment/risk stratification

DOI of Published Version



Am J Transplant. 2018 Aug;18(8):1865-1874. doi: 10.1111/ajt.14945. Epub 2018 Jun 16. Link to article on publisher's site

Journal/Book/Conference Title

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

Related Resources

Link to Article in PubMed

PubMed ID