Liver graft preconditioning, preservation and reconditioning

Liver transplantation; Preconditioning; Preservation; Reconditioning; End Stage Liver Disease; Graft Survival; Humans; Ischemic Preconditioning; Liver; Liver Transplantation; Organ Preservation; Randomized Controlled Trials as Topic; Reperfusion Injury; Transplantation Conditioning; aminotransferase; hypoxia inducible factor 1alpha; interleukin 2; interleukin 6; methylprednisolone; tumor necrosis factor; cold ischemia; cryopreservation; enzyme release; gene expression; graft failure; graft survival; human; hypothermic machine perfusion; ischemic preconditioning; liver graft; liver perfusion; liver preservation; multicenter study (topic); nonhuman; normothermic machine perfusion; priority journal; randomized controlled trial (topic); reperfusion injury; Review; end stage liver disease; liver; liver transplantation; organ preservation; procedures; transplantation conditioning; vascularization

Abstract :

[en] Liver transplantation is the successful treatment of end-stage liver disease; however, the ischaemia-reperfusion injury still jeopardizes early and long-term post-transplant outcomes. In fact, ischaemia-reperfusion is associated with increased morbidity and graft dysfunction, especially when suboptimal donors are utilized. Strategies to reduce the severity of ischaemia-reperfusion can be applied at different steps of the transplantation process: organ procurement, preservation phase or before revascularization. During the donor procedure, preconditioning consists of pre-treating the graft prior to a sustained ischaemia either by a transient period of ischaemia-reperfusion or administration of anti-ischaemic medication, although a multi-pharmacological approach seems more promising. Different preservation solutions were developed to maintain graft viability during static cold storage, achieving substantial results in terms of liver function and survival in good quality organs but not in suboptimal ones. Indeed, preservation solutions do not prevent dysfunction of poor quality organs and are burdened with inadequate preservation of the biliary epithelium. Advantages derived from either hypo- or normothermic machine perfusion are currently investigated in experimental and clinical settings, suggesting a reconditioning effect possibly improving hepatocyte and biliary preservation and resuscitating graft function prior to transplantation. In this review, we highlight acquired knowledge and recent advances in liver graft preconditioning, preservation and reconditioning. © 2016 Editrice Gastroenterologica Italiana S.r.l.

Disciplines :

Surgery

Author, co-author :

Gilbo, NICHOLAS ; Université de Liège - ULiège > Département des sciences cliniques > Pathologie chirurgicale abdominale et endocrinienne ; Centre Hospitalier Universitaire de Liège - CHU > > Service de chirurgie abdo, sénologique, endocrine et de transplantation

Catalano, G; Liver Transplantation Center, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy

Salizzoni, M; Liver Transplantation Center, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy

Romagnoli, R; Liver Transplantation Center, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy

Language :

English

Title :

Liver graft preconditioning, preservation and reconditioning

Publication date :

2016

Journal title :

Digestive and Liver Disease

ISSN :

1590-8658

eISSN :

1878-3562

Publisher :

Elsevier B.V.

Volume :

Issue :

Pages :

1265 - 1274

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 25 January 2024

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