title: Cold storage or normothermic perfusion for liver transplantation: probable application and indications.
abstract: OBJECTIVE
  Preservation of the liver via normothermic machine perfusion (NMP) is rapidly becoming an area of great academic and clinical interest. This review focuses on the benefits and limitations of NMP and where the role for static cold storage may lie.
  
  
  RESULTS
  Clinical studies have recently been published reporting the use of NMP in liver preservation for transplantation. They have described the technology to be well tolerated and feasible with potentially improved posttransplant outcomes. NMP facilitates extended preservation times as well as the potential to increase organ utilization through viability assessment and regeneration. However, this technology is considerably more costly than cold storage and carries significant logistical challenges. Cold storage remains the gold standard preservation for standard criteria livers with good long-term patient and graft survival.
  
  
  CONCLUSIONS
  NMP is an exciting new technological advancement in liver preservation, which is likely to have a positive impact in liver transplantation. However, randomized controlled trials are required to justify its inclusion into standard practice and provide evidence to support its efficacy.
authors.affiliation: Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
authors.forename: Carlo D L
authors.initials: CDL
authors.lastname: Ceresa
authors.forename: David
authors.initials: D
authors.lastname: Nasralla
authors.forename: Simon
authors.initials: S
authors.lastname: Knight
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Friend
mesh_terms: D015925:Cryopreservation / Q000379:methods*; D006801:Humans; D008099:Liver / Q000473:pathology*; D016031:Liver Transplantation / Q000379:methods*; D009926:Organ Preservation / Q000379:methods*; D010477:Perfusion / Q000379:methods*