{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:43:35Z","timestamp":1790383415305,"version":"4.1.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T00:00:00Z","timestamp":1579564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T00:00:00Z","timestamp":1579564800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:p>The primary aim of this single\u2010center, phase 1 exploratory study was to investigate the safety, feasibility, and impact on intrahepatic hemodynamics of a fresh frozen plasma (FFP)\u2013based perfusate in ex situ liver normothermic machine perfusion (NMP) preservation. Using an institutionally developed perfusion device, 21 livers (13 donations after brain death and 8 donations after circulatory death) were perfused for 3\u00a0hours 21\u00a0minutes to 7\u00a0hours 52\u00a0minutes and successfully transplanted. Outcomes were compared in a 1:4 ratio to historical control patients matched according to donor and recipient characteristics and preservation time. Perfused livers presented a very low resistance state with high flow during ex situ perfusion (arterial and portal flows 340\u00a0\u00b1\u00a0150 and 890\u00a0\u00b1\u00a070\u00a0mL\/minute\/kg liver, respectively). This hemodynamic state was maintained even after reperfusion as demonstrated by higher arterial flow observed in the NMP group compared with control patients (220\u00a0\u00b1\u00a0120 versus 160\u00a0\u00b1\u00a080\u00a0mL\/minute\/kg liver, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.03). The early allograft dysfunction (EAD) rate, peak alanine aminotransferase (ALT), and peak aspartate aminotransferase (AST) levels within 7 days after transplantation were lower in the NMP group compared with the control patients (EAD 19% versus 46%, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.02; peak ALT 363\u00a0\u00b1\u00a0318 versus 1021\u00a0\u00b1\u00a0999 U\/L, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.001; peak AST 1357\u00a0\u00b1\u00a01492 versus 2615\u00a0\u00b1\u00a02541 U\/L, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.001 of the NMP and control groups, respectively). No patient developed ischemic type biliary stricture. One patient died, and all other patients are alive and well at a follow\u2010up of 12\u201035 months. No device\u2010related adverse events were recorded. In conclusion, with this study, we showed that ex situ NMP of human livers can be performed safely and effectively using a noncommercial device and an FFP\u2010based preservation solution. Future studies should further investigate the impact of an FFP\u2010based perfusion solution on liver hemodynamics during ex situ normothermic machine preservation.<\/jats:p>","DOI":"10.1002\/lt.25668","type":"journal-article","created":{"date-parts":[[2019,10,23]],"date-time":"2019-10-23T08:09:41Z","timestamp":1571818181000},"page":"215-226","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Ex Situ Liver Machine Perfusion: The Impact of Fresh Frozen Plasma"],"prefix":"10.1097","volume":"26","author":[{"given":"Qiang","family":"Liu","sequence":"first","affiliation":[{"name":"Transplantation Center,Department of Surgery,Digestive Disease Institute,Cleveland Clinic,Cleveland,OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Hassan","sequence":"additional","affiliation":[{"name":"Transplantation Center,Department of Surgery,Digestive Disease Institute,Cleveland 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