Normothermic machine perfusion for older transplant recipients

Introduction Elderly patients (≥65 years old) are increasingly undergoing liver transplantation and are more likely to be removed from the waitlist. Normothermic machine perfusion (NMP) holds promise in expanding the number of livers available for transplant and improving outcomes for marginal donors and recipients. We aimed to determine the impact of NMP on outcomes in elderly recipients at our institution and nationally using the UNOS database. Methods The use of NMP on outcomes in elderly recipients was reviewed using both the UNOS/SRTR database (2016–2022) and institutional data (2018–2020). Characteristics and clinical outcomes were compared between the NMP and static cold (control) groups within both populations. Results Nationally, using the UNOS/SRTR database, we identified 165 elderly recipients from 28 centers who received a liver allograft undergoing NMP and 4270 that underwent traditional cold static storage. NMP donors were older (48.3 vs. 43.4 years, p