{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:43:03Z","timestamp":1785768183510,"version":"3.56.0"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,3,30]],"date-time":"2024-03-30T00:00:00Z","timestamp":1711756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>Clinical adoption of ex situ liver perfusion is growing. While hypothermic perfusion protects against ischemia\u2013reperfusion injury in marginal grafts, normothermic perfusion enables organ viability assessment and therefore selection of borderline grafts. The combination of hypothermic and normothermic perfusion, known as \u201ccold\u2010to\u2010warm,\u201d may be the optimal sequence for organ preservation, but is difficult to achieve with most commercial perfusion systems. We developed an adaptable customized circuit allowing uninterrupted \u201ccold\u2010to\u2010warm\u201d perfusion and conducted preclinical studies on healthy porcine livers and discarded human livers to demonstrate the circuit's efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In collaboration with bioengineers, we developed a customized circuit that adapts to extracorporeal circulation consoles used in cardiovascular surgery and includes a proprietary reservoir enabling easy perfusate change without interrupting perfusion. This preclinical study was conducted on porcine and human livers. Perfusion parameters (pressures, flows, oxygenation) and organ viability were monitored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The customized circuit was adapted to a LivaNova S5\u00ae console, and the perfusions were flow\u2010driven with real\u2010time pressure monitoring. Ten porcine liver and 12 discarded human liver perfusions were performed during 14 to 18\u2009h and 7 to 25\u2009h, respectively. No hyperpressure was observed (porcine and human portal pressure 2\u20136 and 2\u20138\u2009mm\u2009Hg; arterial pressure 10\u201365 and 20\u201365\u2009mm\u2009Hg, respectively). No severe histological tissue injury was observed (Suzuki score\u2009\u2264\u20093 at the end of perfusion). Seven (70%) porcine livers and five (42%) human livers met the UK viability criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The customized circuit and system design enables smooth uninterrupted \u201ccold\u2010to\u2010warm\u201d perfusion not present in current commercial perfusion systems.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aor.14743","type":"journal-article","created":{"date-parts":[[2024,3,30]],"date-time":"2024-03-30T09:03:16Z","timestamp":1711789396000},"page":"876-890","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Preclinical validation of a customized circuit for ex situ uninterrupted cold\u2010to\u2010warm prolonged perfusion of the liver"],"prefix":"10.1111","volume":"48","author":[{"given":"Olivier","family":"Scatton","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Surgery and Liver Transplantation Sorbonne Universit\u00e9, H\u00f4pital Piti\u00e9\u2010Salp\u00eatri\u00e8re, Assistance Publique\u2014H\u00f4pitaux de Paris  Paris France"},{"name":"INSERM UMRS\u2010938, Centre de Recherche Saint\u2010Antoine (CRSA) Sorbonne Universit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9999-1603","authenticated-orcid":false,"given":"C\u00e9lia","family":"Turco","sequence":"additional","affiliation":[{"name":"INSERM UMRS\u2010938, Centre de Recherche Saint\u2010Antoine (CRSA) Sorbonne Universit\u00e9  Paris France"},{"name":"Liver Transplantation Unit, Department of Digestive and Oncologic Surgery University Hospital of Besan\u00e7on  Besan\u00e7on France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Savier","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery and Liver Transplantation Sorbonne Universit\u00e9, H\u00f4pital Piti\u00e9\u2010Salp\u00eatri\u00e8re, Assistance 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Sorbonne Universit\u00e9, H\u00f4pital Piti\u00e9\u2010Salp\u00eatri\u00e8re, Assistance Publique\u2014H\u00f4pitaux de Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynda","family":"Aoudjehane","sequence":"additional","affiliation":[{"name":"INSERM UMRS\u2010938, Centre de Recherche Saint\u2010Antoine (CRSA) Sorbonne Universit\u00e9  Paris France"},{"name":"INSERM, Institute of Cardiometabolism and Nutrition (ICAN) Sorbonne Universit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Wendum","sequence":"additional","affiliation":[{"name":"Department of Pathology Saint\u2010Antoine Hospital (AP\u2010HP)  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Migliazza","sequence":"additional","affiliation":[{"name":"Department of Discovery, Research and Development LivaNova PLC  London 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