Application of ex vivo liver perfusion in hepatoma research

Abstract

Hepatocellular carcinoma remains a leading cause of cancer-related mortality worldwide. Despite advances in surgical and systemic therapies, recurrence rates remain high, and translational models for therapeutic testing are limited. This review explores the evolving role of ex vivo liver perfusion (EVLP) as a translational platform in hepatoma research, highlighting its applications in tumour modelling, therapeutic testing, and biomarker discovery. A narrative synthesis of recent literature was performed, focusing on EVLP modalities such as normothermic machine perfusion, hypothermic oxygenated perfusion, split-liver perfusion, and segmental perfusion of resected tumour-bearing tissue. EVLP preserves hepatic architecture and metabolic function, enabling real-time study of tumour microenvironments, pharmacological responses, and recurrence mechanisms. Segmental perfusion provides an ethically viable translational model. Overall, EVLP represents a transformative tool in hepatobiliary oncology, bridging the gap between in vitro models and clinical practice, enhancing mechanistic understanding, and accelerating therapeutic innovation.

Keywords

Ex vivo liver perfusion / normothermic perfusion / segmental perfusion / split-liver

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