Strategies for normothermic preservation of livers

Cold preservation is currently the basis of organ preservation. However, prolonged duration of cold storage or preservation of marginal organs leads to inferior outcome. Primary non-function of liver occurs in 3.5-6% of patients requiring retransplantation. Many marginal organs such as severely steatotic livers and non-heart-beating donor livers are either not retrieved or discarded after retrieval due to concerns regards viability. A better method of preservation could enable utilisation of many of these organs and increase the donor pool. This thesis describes and demonstrates successful preservation of livers at body temperature using normothermic perfusion. It aims to make preservation physiological, improve outcomes following transplantation and increase the number of donor livers that can be transplanted by allowing use of more marginal livers.