It is safe for patients to receive donor livers that have been preserved overnight using machine perfusion, enabling these transplants to take place during the day, according to an April 3 announcement from the University Medical Center Groningen (UMCG) in The Netherlands.
The study found that post-transplant outcomes for patients who received livers preserved with this method were at least as good as those for recipients of livers not treated with machine perfusion or treated only briefly. This development is significant because it allows transplant teams to better schedule surgeries and avoid last-minute nighttime procedures, which can disrupt other scheduled operations and increase stress among medical staff.
According to De Meijer, "In 2021 and 2022, approximately 50% of liver transplants took place during the day, but with the new technology, this has risen to nearly 90% in 2023 and 2024. This means we have to conduct liver transplants at the last minute much less often. That could have consequences for other already scheduled surgeries, which sometimes had to be postponed as a result. Prolonged hypothermic machine perfusion has increased flexibility, our medical staff experience less stress and patients can be better cared for. It also makes complex combined transplants possible, such as heart-liver or lung-liver transplants, which in the Netherlands are performed only in Groningen. No one wants to go back to the old situation."
The study examined all possible patient outcomes one year after transplantation—including complications, survival rates, blood loss during surgery and length of hospital stay—and found that intentionally extended preservation with machine perfusion resulted in care quality equal or superior to previous methods. De Meijer said: "For all these factors, the quality following intentionally extended preservation with machine perfusion is at least as good as that of transplants in which the liver was not treated with machine perfusion or was treated for only a short time. This means not only that we can now plan better but also that patients can expect the same quality of care.'"
An important finding from this research is its application across all types of donor organs—including those from donors who died following cardiac arrest—as well as its demonstration that cooled machine perfusion enables longer preservation times without negative effects on recipient outcomes.
De Meijer described a world record achieved by his team: "We successfully transplanted a liver even after more than 31 hours outside the body including 24 hours on the pump." He added: "It confirms that machine perfusion makes it possible to preserve donor livers longer, schedule transplants more effectively reduce time pressure and stress among physicians and achieve exceptionally good outcomes for patients. Every patient deserves a well-equipped surgical team and I hope that following UMCG's lead this technique will be introduced in more centers!"
Instead of storing organs simply on ice prior to transplantation—a traditional method—the UMCG uses machines supplying oxygenated fluid at ten degrees Celsius before transplanting into recipients.
