Machine Perfusion Technology for Reduction of the Risk of Non‐Anastomotic Biliary Stricture in Liver Transplantation

ABSTRACT In many countries, use of organs sourced by donation after circulatory death can effectively alleviate the present organ shortage. However, biliary complications, particularly non‐anastomotic biliary stricture, following transplantation of livers from donation after circulatory death donors significantly affects the prognosis of the recipient and limits organ utilization. Recent rapid advances in machine technology have improved post‐transplant graft function and been shown to protect against non‐anastomotic biliary stricture. This review summarizes the protective mechanisms and clinical outcomes of hypothermic oxygenated machine perfusion, normothermic machine perfusion, and normothermic regional perfusion for donation after circulatory death liver transplantation and discusses the prospects for further development of machine perfusion and ischemia‐free organ transplantation technology.