title: Machine perfusion in solid organ transplantation: where is the benefit?
abstract: BACKGROUND
  Machine perfusion (MP) in solid organ transplantation has been a topic of variable importance for decades. At the dawn of organ transplantation, MP was one of the standard techniques for preservation; today's gold standard for organ preservation for transplantation is cold storage (CS). The outcome after transplantation of solid organs has tremendously improved over the last five decades. MP has been continuously under investigation and may be an option for organ preservation in selected cases; however, there is only little evidence from clinical trials that can be used to advocate for MP as a routine organ preservation method.
  
  
  METHODS
  This article reviews the current knowledge on MP in the field of solid organ transplantation with special focus on findings from clinical trials.
  
  
  CONCLUSIONS
  Especially in heart and lung transplantation, MP seems to be a promising tool to improve postoperative outcome, but a general evidence-based recommendation for or against an application of MP cannot be given due to the lack of the highest level of clinical evidence. Gold standards such as CS should not be left behind without good reason. Randomized clinical trials are desperately needed to further improve outcome and for better understanding of the underlying pathophysiological mechanisms.
authors.affiliation: Department of General and Transplant Surgery, Ruprecht Karls University, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: Helge
authors.initials: H
authors.lastname: Bruns
authors.forename: Peter
authors.initials: P
authors.lastname: Schemmer
mesh_terms: D002986:Clinical Trials as Topic; D006085:Graft Survival; D006801:Humans; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D016377:Organ Transplantation; D010477:Perfusion / Q000379:methods*
chemical_list: D019188:Organ Preservation Solutions