An adaptable research platform for ex vivo normothermic machine perfusion of the liver

Int J Comput Assist Radiol Surg. 2023 Jun;18(6):1101-1108. doi: 10.1007/s11548-023-02903-4. Epub 2023 Apr 24.

Abstract

Purpose: This paper presents an assessment of a low-cost organ perfusion machine designed for use in research settings. The machine is modular and versatile in nature, built on a robotic operating system (ROS2) pipeline allowing for the addition of specific sensors for different research applications. Here we present the system and the development stages to achieve viability of the perfused organ.

Methods: The machine's perfusion efficacy was assessed by monitoring the distribution of perfusate in livers using methylene blue dye. Functionality was evaluated by measuring bile production after 90 min of normothermic perfusion, while viability was examined using aspartate transaminase assays to monitor cell damage throughout the perfusion. Additionally, the output of the pressure, flow, temperature, and oxygen sensors was monitored and recorded to track the health of the organ during perfusion and assess the system's capability of maintaining the quality of data over time.

Results: The results show the system is capable of successfully perfusing porcine livers for up to three hours. Functionality and viability assessments show no deterioration of liver cells once normothermic perfusion had occurred and bile production was within normal limits of approximately 26 ml in 90 min showing viability.

Conclusion: The developed low-cost perfusion system presented here has been shown to keep porcine livers viable and functional ex vivo. Additionally, the system is capable of easily incorporating several sensors into its framework and simultaneously monitor and record them during perfusion. The work promotes further exploration of the system in different research domains.

Keywords: Liver preservation; Machine perfusion; Systems design.

MeSH terms

  • Animals
  • Liver
  • Liver Transplantation*
  • Organ Preservation / methods
  • Perfusion / methods
  • Swine
  • Temperature