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Technique of Subnormothermic Ex Vivo Liver Perfusion for the Storage, Assessment, and Repair of Marginal Liver Grafts
Published on: August 13, 2014
15.7K
Liver graft preconditioning, preservation and reconditioning
Nicholas Gilbo1, Giorgia Catalano1, Mauro Salizzoni1
1Liver Transplantation Center, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy.
Summary
Ischaemia-reperfusion injury impacts liver transplant outcomes. Strategies like preconditioning, preservation solutions, and machine perfusion aim to reduce injury and improve graft function, especially for suboptimal organs.
Area of Science:
- Transplantation immunology
- Organ preservation
- Graft viability
Background:
- Liver transplantation treats end-stage liver disease but is threatened by ischaemia-reperfusion (I/R) injury.
- I/R injury increases morbidity and graft dysfunction, particularly with suboptimal donor organs.
Purpose of the Study:
- To review advances in mitigating I/R injury in liver transplantation.
- To highlight strategies for liver graft preconditioning, preservation, and reconditioning.
Main Methods:
- Review of current knowledge and recent advancements in liver graft management.
- Exploration of preconditioning techniques, preservation solutions, and machine perfusion methods.
Main Results:
- Preconditioning involves graft treatment before ischaemia, with multi-pharmacological approaches showing promise.
- Static cold storage solutions are effective for good quality organs but not suboptimal ones, and inadequately preserve biliary epithelium.
- Hypo- and normothermic machine perfusion are being investigated for their reconditioning effects on hepatocytes and biliary epithelium.
Conclusions:
- Reducing I/R injury is crucial for successful liver transplantation, especially for suboptimal grafts.
- Novel strategies like machine perfusion offer potential for improved graft preservation and function resuscitation.
