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      "text": "Dec 2024 study on liver damage from warm perfusion machines",
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      "text": "“a comprehensive mechanistic assessment of NMP is still lacking”",
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      "text": "Machine perfusion vendors like TransMedics would jeopardize their existence by studying such damage, but we note emerging studies like one just published in Dec 2024 measuring biomarker concentration in perfusate samples from a pump",
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      "text": "Closely related to warm ischemic time is the time the organ is on the pump. Although time on pump is not explicitly indicated on the label, it was a key measure in the pivotal trial and FDA approval. The OCS Liver PROTECT trial doesn't appear to specify the average pump duration, but surgeons indicated it was short – around 6 hours, with some up to 8-10 – given damage the longer a liver is perfused outside a body. Our review of the clinical literature indicates significant organ damage with extended warm perfusion periods >10 hours, such as hepatocellular damage, reperfusion injury, and histological changes. Machine perfusion vendors like TransMedics would jeopardize their existence by studying such damage, but we note emerging studies like one just published in Dec 2024 measuring biomarker concentration in perfusate samples from a pump – showing \"significant accumulation of markers\" for injury and pathological processes; \"a self-perpetuating cycle of inflammation and additional cell damage\"; \"which may limit the extent of benefit of this technology....\"",
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      "text": "studied. Normothermic machine perfusion (NMP) tries to rebalance cellular metabolism by maintaining the organ at physiological temperature and also supplying oxygen and nutrients. Although these conditions may allow viability assessment before using these organs for liver transplantation (LT), a comprehensive mechanistic assessment of NMP is still lacking. Moreover, this is an essential step toward identifying biomarkers to assess and predict liver function and viability after LT.",
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      "text": "“significant accumulation of markers” for injury and pathological processes; “a self-perpetuating cycle of inflammation and additional cell damage”; “which may limit the extent of benefit of this technology….” — Dec 2024 study on liver damage from warm perfusion machines",
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      "text": "Source: Scorpion Capital consultation calls with experts; https://journals.lww.com/transplantationdirect/fulltext/2024/12000/dynamics_of_ischemia_reperfusion_injury_markers.8.aspx",
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      "kind": "title",
      "text": "Dynamics of Ischemia/Reperfusion Injury Markers During Normothermic Liver Machine Perfusion",
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