MARCO MİGGİNO, GİOVANNİ VAROTTİ, PAOLO MONTANELLİ, GİULİANO BOTTİNO, EVA MORAGLİA, ELİSA PORCİLE, ENZO ANDORNO
Experimental and Clinical Transplantation - 2024;22(8):650-653
The use of marginal donor livers, particularly steatotic livers, could help to resolve the problem of organ shortage and wait list mortality. Ischemia-free liver transplant with the potential to avoid ischemia-reperfusion injury and related complications, parti-cularly early allograft dysfunction, could positively encourage the use of marginal donor livers and extend the donor pool. Here, we describe the first case in a Western country of ischemia-free liver transplant of a marginal donor liver. To date, a research team in China is the only group to have described and used this technique. The technical and setup aspects are illustrated, and present controversies are discussed. A 58-year-old female patient received a transplant of a >60% steatotic donor liver. The transplant was accomplished with the ischemia-free liver transplant technique, and the donor liver was procured and transplanted under continuous normothermic machine perfusion. The donor liver functional para-meters under normothermic machine perfusion were reassuring, and recipient recovery was uneventful. Although ischemia-free liver transplant is a technically and organizationally demanding procedure, our case demonstrates the feasibility of the ischemia-free liver transplant technique and encourages the develop-ment and expansion of its use.
