Machine perfusion of the liver: Putting the puzzle pieces together

Figure 1 Conditions favouring the development of machine perfusion of the liver. At the start of transplantation, the utilization of good quality donor organs and the low price and simplicity of static cold storage (SCS) favoured its general use. However, the rise in demand for liver transplantation and the donor organ demographic change imposed a frequent utilization of extended criteria donor (ECD) organs. ECD liver transplantation presented inferior results, exposing the limitations of SCS. This scenario, allied to the technological development, created a favourable environment and renewed interest in dynamic organ preservation.