Endothelial Cells and Mitochondria: Two Key Players in Liver Transplantation

Building the inner layer of our blood vessels, the endothelium forms an important line communicating with deeper parenchymal cells in our organs. Previously considered passive, endothelial cells are increasingly recognized as key players in intercellular crosstalk, vascular homeostasis, and blood fluidity. Comparable to other cells, their metabolic function strongly depends on mitochondrial health, and the response to flow changes observed in endothelial cells is linked to their mitochondrial metabolism. Despite the direct impact of new dynamic preservation concepts in organ transplantation, the impact of different perfusion conditions on sinusoidal endothelial cells is not yet explored well enough. This article therefore describes the key role of liver sinusoidal endothelial cells (LSECs) together with their mitochondrial function in the context of liver transplantation. The currently available ex situ machine perfusion strategies are described with their effect on LSEC health. Specific perfusion conditions, including perfusion pressure, duration, and perfusate oxygenation are critically discussed considering the metabolic function and integrity of liver endothelial cells and their mitochondria.

Automated summary

The endothelium, forming the inner layer of blood vessels, plays a crucial role in intercellular communication and vascular homeostasis. Recent studies have highlighted the importance of endothelial cells in metabolic function and their response to flow changes, which are linked to mitochondrial health. The impact of different perfusion conditions on liver sinusoidal endothelial cells (LSECs) and their mitochondrial function in the context of liver transplantation is discussed in this article. The available ex situ machine perfusion strategies and their effects on LSEC health are described, with a focus on specific perfusion conditions such as pressure, duration, and oxygenation.