Normothermic machine perfusion of donor livers for transplantation in the United States. A randomized controlled trial.

Chapman WC, Barbas AS, D’Alessandro AM, Vianna R, Kubal CA, Abt P et al.

Ann Surg 2023; 278: e912-e921.

Some 383 donor organs were randomized, and 266 implanted. The rate of early graft dysfunction was similar in perfused livers (20.6 per cent) and after cold storage (23.7 per cent). Exploratory subgroup analyses suggested there could be circumstances where machine perfusion was beneficial: high risk livers, and those donated after circulatory death.

Comment: Appears not to be beneficial for every liver for transplantation, but still may be useful in selected situations.