Metabolic and lipidomic profiling of steatotic human livers during ex situ normothermic machine perfusion guides resuscitation strategies

Siavash Raigani, Negin Karimian, Viola Huang, Anna M. Zhang, Irene Beijert, Sharon Geerts, Sonal Nagpal, Ehab O.A. Hafiz, Fermin M. Fontan, Mohamed M. Aburawi, Paria Mahboub, James F. Markmann, Robert J. Porte, Korkut Uygun, Martin Yarmush, Heidi Yeh

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


There continues to be a significant shortage of donor livers for transplantation. One impediment is the discard rate of fatty, or steatotic, livers because of their poor post-transplant function. Steatotic livers are prone to significant ischemia-reperfusion injury (IRI) and data regarding how best to improve the quality of steatotic livers is lacking. Herein, we use normothermic (37°C) machine perfusion in combination with metabolic and lipidomic profiling to elucidate deficiencies in metabolic pathways in steatotic livers, and to inform strategies for improving their function. During perfusion, energy cofactors increased in steatotic livers to a similar extent as non-steatotic livers, but there were significant deficits in anti-oxidant capacity, efficient energy utilization, and lipid metabolism. Steatotic livers appeared to oxidize fatty acids at a higher rate but favored ketone body production rather than energy regeneration via the tricyclic acid cycle. As a result, lactate clearance was slower and transaminase levels were higher in steatotic livers. Lipidomic profiling revealed ω-3 polyunsaturated fatty acids increased in non-steatotic livers to a greater extent than in steatotic livers. The novel use of metabolic and lipidomic profiling during ex situ normothermic machine perfusion has the potential to guide the resuscitation and rehabilitation of steatotic livers for transplantation.

Original languageEnglish (US)
Article numbere0228011
JournalPloS one
Issue number1
StatePublished - Jan 1 2020

Bibliographical note

Funding Information:
This work received funding from the US National Institutes of Health (grants R01DK096075, R01DK107875, R21EB020819, R01DK084053 and R01DK114506) to HY, KU, MY.

Publisher Copyright:
© 2020 Raigani et al.


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