SimLivA II – SIMulation supported LIVer Assessment for donor organs II - Continuum-biomechanical modeling for staging of ischemiareperfusion injury during liver transplantation and machine perfusion

Background: Liver transplantation (LTx) is the only curative treatment option for acute and chronic end-stage liver disease. Demographic change and western lifestyle result in an increasing rate of elderly multi-morbid potential recipients and donors. Liver grafts from such donors, so-called marginal liver grafts, are often affected by hepatic steatosis compromising the quality of the donor organ substantially. One reason is the alteration of the tissue structure, resulting in an impaired perfusion, which in turn affects hepatic metabolism and organ function. In case of a marginal graft, the surgeon is faced with the clinical decision to either accept or reject the organ, significantly increasing the postoperative risk for the recipient or increasing the risk of death on the waiting list, respectively. Two major challenges for marginal grafts are the storage between procurement of the organ and transplantation (cold ischemia time) and damage after reperfusion (ischemia-reperfusion injury or IRI). Machine perfusion is currently the most promising strategy for prolonging the viability of organs from marginal donors. Goal: Our co-designed interdisciplinary project “SIMulation supported LIVer Assessment for donor organs (SimLivA 2)” aims to mathematically model the effects of different machine perfusion strategies on organ vitality.