Upfront Normothermic Machine Perfusion for a Liver Graft with Severe Macrovesicular Steatosis: A Proof-of-Concept Case

Graft steatosis has been associated with inferior outcomes after liver transplantation. Given the rising prevalence of obesity and fatty disease, strategies allowing safe successful utilization grafts are needed. Liver preservation by normothermic machine perfusion (NMP) allows reducing ischemia-reperfusion injury, extending time assessing graft viability prior to implantation into recipient. NMP can be initiated at donor hospital using a transportable device (referred as upfront or preservation) period cold ischemia (known back-to-base). In this report, we present case from an HCV-positive DBD 70% macrovesicular steatosis, which was successfully preserved transplanted NMP. This approach key minimize initial injury allowed its before transplantation, while improving transplant logistics. Upfront represents promising enhance transplantation grafts.