Researchers have developed a real-time monitoring system designed to give transplant teams a more complete picture of a donor liver’s health during machine perfusion.
Published in Nature Communications, the study by researchers at Mayo Clinic, Arizona, in collaboration with the Terasaki Institute for Biomedical Innovation in Los Angeles, represents an important step toward more accurate evaluation of donor livers, laying the groundwork for future advances in organ preservation and transplantation.
During machine perfusion, a donor liver is connected to a device that pumps oxygen-rich fluid through the organ while outside the body.
“Machine perfusion is opening the door to a future where we don’t just evaluate organs, we treat them and even improve them before transplant,” said Michelle Nguyen, MD, a transplant surgeon at Mayo Clinic in Arizona and co-corresponding author of the study. “But to get there, we first need better ways to understand how an organ is performing in real time. That’s what this technology is built to provide.”
Today’s monitoring methods rely on manually collecting fluid samples from the organ every 30 to 60 minutes, testing them on point-of-care devices or sending them to a laboratory for analysis. Those periodic snapshots may miss important changes occurring between samples.
Detecting biochemical changes or signs that organ health is declining early allows clinicians and perfusionists to intervene before permanent damage occurs.
To address this challenge, researchers developed a new wireless sensor platform that continuously measures glucose, lactate and pH in both the perfusion fluid and bile; streaming results to the care team in real time.
In the study, the sensor’s measurements closely matched standard laboratory testing while also detecting brief biochemical changes between routine sampling intervals. The findings suggest that real-time monitoring of bile, in addition to perfusion fluid, may provide valuable information about the health of the donated liver that current approaches may be unable to detect.
“Every organ donated is incredibly valuable,” Nguyen said. “By giving transplant teams a clearer understanding of an organ’s health, we’re working toward a future where more donated livers can safely reach the patients who need them most.”
Researchers note that larger studies will be needed to further evaluate the technology and its potential to improve donor organ assessment. Looking ahead, the team is working to expand the sensor platform to capture additional markers of organ health, creating a more comprehensive assessment panel.
Researchers also plan to adapt the technology for other organs, including the kidney, heart and lung.
The study was co-led by Nguyen and Yangzhi Zhu, PhD, of the Terasaki Institute for Biomedical Innovation.
Study details
A clinically deployed dual-compartment biochemical monitoring platform for human liver perfusion
Keren Zhou, Minwoo Kim, Chia-Wei Liu, Jack Harbell et al.
Published in Nature Communications on 14 July 2026
Abstract
The global shortage of transplantable donor livers increases reliance on marginal grafts, creating an urgent need for workflow-compatible assessment during normothermic machine perfusion. However, current biochemical evaluation remains constrained by intermittent perfusate sampling, low temporal resolution and limited cholangiobiliary context. Here we report a clinically deployed dual-compartment biochemical monitoring (DCBM) platform for human liver perfusion. The system integrates dual-channel microfluidics, multiplexed electrochemical sensing, bile-compatible antifouling interfaces and wireless data transmission to enable automated in-line measurement of pH, lactate and glucose in both perfusate and bile. In seven human donor livers, the DCBM platform shows strong agreement with standard laboratory assays while resolving transient biochemical excursions not captured by scheduled hourly sampling, including bile lactate elevations associated with subsequent adverse perfusion trends in selected cases. Continuous dual-compartment measurements further enable an exploratory outcome-anchored framework linked to post-transplant clinical course. This platform establishes a clinically deployed architecture for dual-compartment biochemical monitoring and provides an initial translational bridge from continuous sensing to viability-associated graft assessment during ex situ liver perfusion.
See more from MedicalBrief archives:
Swiss liver transplant using perfusion opens new doors for rejected donors
Liver perfusion could save 7 in 10 rejected donor livers