Machine Perfusion Preservation as a Platform for Advanced Liver Surgery

IF 2.2 3区医学 Q3 ENGINEERING, BIOMEDICAL

Artificial organs Pub Date : 2026-09-29 Epub Date: 2026-07-31 DOI:10.1111/aor.70209

Patricia Viana, Michael Irby, Narendra R. Battula, Maheshwaran Pitchaimuthu, Barish Edil, Ajay Jain, Claire Goumard, Olivier Scatton, Paulo N. Martins

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引用次数: 0

Abstract

Objective

To review the role of machine perfusion in complex in situ and ex situ liver resections and its potential to improve perioperative and oncologic outcomes.

Summary Background Data

Complex liver resections requiring prolonged vascular exclusion are limited by ischemia reperfusion injury and postoperative liver failure. Machine perfusion, established in liver transplantation to enhance organ preservation and functional assessment, is increasingly applied to advanced hepatobiliary surgery.

Methods

A narrative review of experimental and clinical studies evaluating hypothermic and normothermic machine perfusion in in situ and ex situ liver surgery was performed.

Results

Current evidence indicates that machine perfusion is feasible and safe in complex liver resections, allowing prolonged vascular control while preserving liver function. Early clinical reports demonstrate improved postoperative recovery and successful oncologic resections, with emerging transplant data suggesting a potential reduction in tumor recurrence.

Conclusions

Machine perfusion may expand the boundaries of complex liver surgery by mitigating ischemia reperfusion injury and enabling otherwise unresectable procedures. Prospective studies are required to define optimal perfusion strategies and long term oncologic outcomes.

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机器灌注保存作为高级肝脏手术的平台。

目的：回顾机器灌注在复杂原位和非原位肝切除术中的作用及其改善围手术期和肿瘤预后的潜力。摘要背景资料：复杂的肝切除术需要长时间的血管排除，受缺血再灌注损伤和术后肝衰竭的限制。机器灌注在肝移植中建立，以加强器官保存和功能评估，越来越多地应用于晚期肝胆手术。方法：对原位和非原位肝手术中低温和常温机器灌注的实验和临床研究进行综述。结果：目前的证据表明，机器灌注在复杂的肝切除术中是可行和安全的，可以在保持肝功能的同时延长血管控制。早期临床报告显示术后恢复改善和肿瘤切除成功，新出现的移植数据表明肿瘤复发可能减少。结论：机器灌注可以通过减轻缺血再灌注损伤和使其他不可切除的手术成为可能，从而扩大复杂肝脏手术的范围。需要前瞻性研究来确定最佳灌注策略和长期肿瘤预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Artificial organs 工程技术-工程：生物医学

CiteScore

4.30

自引率

12.50%

发文量

303

审稿时长

4-8 weeks

期刊介绍： Artificial Organs is the official peer reviewed journal of The International Federation for Artificial Organs (Members of the Federation are: The American Society for Artificial Internal Organs, The European Society for Artificial Organs, and The Japanese Society for Artificial Organs), The International Faculty for Artificial Organs, the International Society for Rotary Blood Pumps, The International Society for Pediatric Mechanical Cardiopulmonary Support, and the Vienna International Workshop on Functional Electrical Stimulation. Artificial Organs publishes original research articles dealing with developments in artificial organs applications and treatment modalities and their clinical applications worldwide. Membership in the Societies listed above is not a prerequisite for publication. Articles are published without charge to the author except for color figures and excess page charges as noted.