Liver transplantation: Current status and challenges

Table 1 Comparison of hypothermic and normothermic mechanical perfusion

	Hypothermic mechanical perfusion	Normothermic mechanical perfusion
Temperature	4 °C	37 °C
Pathophysiology	Reduced cellular metabolism	Continued cellular metabolism
	Non-functioning liver during preservation	Functioning liver during preservation
Perfusate	No specific requirements, oxygen can be used	Continuous delivery of nutrients and oxygen needs to be maintained
Logistics	Similar to that of hypothermic mechanical perfusion currently used for renal allografts	More complex
Benefits	Logistically easier	Allows for the assessment of metabolic and synthetic function during preservation
	May provide benefit in marginal livers	May provide benefit in marginal livers
		Potential use in steatotic livers
		Felt to reduce ischemia reperfusion injury