Fig. 7.

20 h of DHOPE preservation of discarded human liver grafts.

(A) pictures of a human liver at the end of DHOPE preservation (left) and during normothermic reperfusion (right). (B) Markers for graft viability. The green margins depict historical data of clinically perfused livers that were deemed viable after 2.5 h of normothermic perfusion and thus accepted for transplantation. The red margins depict historical data of livers that were deemed non-viable after 2.5 h of reperfusion, which were secondarily discarded for transplantation. The purple and blue lines represent the 2 livers included in this study. Both livers follow the green margins, indicative of a viable graft. Shown are lactate clearance, the delta of biliary and arterial pH, the biliary/arterial glucose ratio, and the delta of biliary and arterial bicarbonate. After 2.5 h, both livers meet the viability criteria. (C) Hepatic ATP content at the end of DHOPE, and perfusate levels of HMGB-1, TNFα, IL-6, and cfDNA during DHOPE preservation. (D) H&E staining of extrahepatic bile ducts (left), intrahepatic bile ducts (middle), and liver parenchyma (right), ∗ = bile duct lumen. cfDNA, cell-free DNA; DHOPE, dual hypothermic oxygenated machine perfusion; HMGB-1, high-mobility group 1; IL-6, interleukin 6; TNFα, tumor necrosis factor alpha.