Perfusion machines for liver transplantation: technology and multifunctionality.

The reliability of machine perfusion (alternative to static cold storage) for the preservation of liver for transplantation has been well investigated in experimental models, by taking into account the temperature, oxygenation, flow, pressure, and settings of the machine or proposed circuit. Machine perfusion is considered by many researchers as a valid method for preserving organs. While circuits or machines for preservation have been described, no agreement has been reached concerning how these devices should be developed. The machines proposed to date are considered here to identify the technical and functional features necessary for a machine to have multifunctionality and adaptability to cater all the needs of preservation, according to the type and features of the liver to be transplanted, including marginal livers. The need to establish a uniform method for the use of this machine is also emphasized, to achieve a clinical protocol for its use.