Advancing Machine Perfusion: Navigating Challenges in Abdominal Organ Transplantation

This research topic explores the critical and unresolved questions surrounding the use of normothermic regional perfusion (NRP), normothermic machine perfusion (NMP), and hypothermic machine perfusion (HMP) in abdominal organ transplantation. These evolving preservation strategies hold significant promise for improving organ quality, increasing utilization, and expanding the donor pool. However, widespread clinical adoption remains limited by logistical, technical, and ethical challenges.

This topic will examine the comparative benefits and limitations of NRP, NMP, and HMP, including their impact on organ viability, ischemic injury mitigation, and post-transplant outcomes such as ischemic cholangiopathy reduction and graft survival improvement. Key technical considerations, such as optimal perfusion protocols and temperature modulation in preservation strategies, will be critically analyzed. Additionally, the discussion will address the ethical, economic, sustainability, and workforce implications of integrating these perfusion techniques into routine clinical practice, particularly in the context of evolving organ allocation policies and resource availability.

By fostering a multidisciplinary dialogue on the latest advancements and challenges in machine perfusion, this research aims to provide a foundation for evidence-based best practices and promote broader adoption of these technologies to enhance the effectiveness, equity, sustainability, and workforce resilience in abdominal organ transplantation. This Research Topic is open to all article types accepted by Frontiers in Transplantation.