Research Group

  • Dr Markus Selzner, Principal Investigator
  • Dr David R. Grant, Co-Investigator
  • Dr Gary A. Levy, Co-Investigator
  • Dr Ian D. McGilvray, Collaboator
  • Dr Nazia Selzner, Collaborator
  • Dr Shaf Keshavjee, Collaborator

Location

  • Toronto General Hospital, Toronto, Canada

Title

  • Oxygenated ex vivo Liver Perfusion as a Novel Technique for Organ Storage, Assessment, and Repair

Liver transplantation is the only chance of cure for patients with end-stage liver disease or advanced liver-cell cancer. The success of liver transplantation has resulted in a dramatic organ shortage. Marginal grafts, such as fatty livers or livers with prolonged ischemia, are a large potential organ source but are often declined for transplantation because of an increased risk of liver failure or patient death after transplantation. Currently organs are stored on ice at 4°C in a preservation solution to allow organ transport, organ sharing, and liver preparation prior to transplantation. Cold static organ storage has the disadvantage that it promotes organ damage, it does not allow the assessment of graft function and liver injury, and prevents the application of repair strategies to the graft. We have developed a novel preservation technique of normothermic, oxygenated ex vivo liver perfusion, which maintains enzyme function, metabolism and liver perfusion during the preservation period. We aim to: 1) compare normothermic ex vivo liver perfusion with cold static preservation in human livers declined for transplantation, 2) identify ex vivo perfusion parameters of human livers predicting post-transplant graft function, and 3) decrease liver injury and improve graft function by modulating mediators of reperfusion injury prior to transplantation. Normothermic ex vivo liver perfusion opens an opportunity for prolonged organ preservation without increasing liver injury and to assess liver graft function and injury prior to transplantation. In addition, the active metabolic function during normothermic ex vivo liver perfusion provides ideal conditions to apply repair strategies to the graft and modulate mediators of reperfusion injury prior to transplantation. Normothermic ex vivo liver perfusion might allow us to increase the donor pool by accepting more marginal livers and to increase the safety of our liver transplant recipients.

Progress Report

Final Report