Static cold storage is currently the most used
method of organ preservation worldwide. However, cutting edge technology and
dramatic changes in the donor pattern have lately renewed the interest toward
hypothermic machine perfusion.
Marginal and cardiac death donors show higher
rates of primary non function and delayed graft function compared to standard
criteria donors. In this setting, machine perfusion may offer several theoretical advantages such as
improved organ preservation,
continuous graft evaluation, and ex-vivo conditioning of the graft before
implantation.
These topics have been recently reassessed by
several studies. In particular, perfusion characteristics and perfusate
biomarker concentrations (lactate dehydrogenase, aspartate aminotransferase,
heart-type fatty acid binding protein, and IL-18) during machine preservation,
proved to be reliable tools to rule out graft viability and predict outcomes
after transplantation.
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