Ex Vivo Normothermic Machine Perfusion

  • Daniele Pezzati
  • Qiang Liu
  • Cristiano QuintiniEmail author


Normothermic machine perfusion (NMP) involves perfusing organs ex vivo with normothermic oxygenated blood–based solutions that recreate the physiological environment, thereby tending to decrease the detrimental effects seen with standard cold storage (SCS). Several different NMP platforms exist that are in various stages of development. NMP has the potential to restore normal metabolic physiology, recondition marginal livers, and allow for the assessment of graft viability. The use of NMP for donation after circulatory death (DCD) liver grafts has been of particular interest, given the additional period of damaging warm ischemia these grafts are exposed to compared to donation after brain death (DBD) liver grafts. The present chapter describes the rationale for NMP, as well as providing a summary of pre-clinical and clinical studies that have investigated its application. The various platforms for NMP that have been utilized are also described.


NMP normothermic machine preservation Machine perfusion DCD organ preservation Ex-vivo machine perfusion 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Daniele Pezzati
    • 1
  • Qiang Liu
    • 2
  • Cristiano Quintini
    • 1
    Email author
  1. 1.Department of General SurgeryCleveland ClinicClevelandUSA
  2. 2.Cleveland Clinic Liver Transplant Center, Department of General SurgeryClevelandUSA

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