期刊
AMERICAN JOURNAL OF TRANSPLANTATION
卷 18, 期 3, 页码 737-744出版社
WILEY
DOI: 10.1111/ajt.14583
关键词
clinical research; practice; liver allograft function; dysfunction; liver transplantation; hepatology; organ perfusion and preservation; organ procurement; surgical technique; translational research; science
资金
- National Natural Science Foundation of China [81570587]
Ischemia and reperfusion injury (IRI) is an inevitable event in conventional organ transplant procedure and is associated with significant mortality and morbidity post-transplantation. We hypothesize that IRI is avoidable if the blood supply for the organ is not stopped, thus resulting in optimal transplant outcomes. Here we described the first case of a novel procedure called ischemia-free organ transplantation (IFOT) for patients with end-stage liver disease. The liver graft with severe macrovesicular steatosis was donated from a 25-year-old man. The recipient was a 51-year-old man with decompensated liver cirrhosis and hepatocellular carcinoma. The graft was procured, preserved, and implanted under continuous normothermic machine perfusion. The recipient did not suffer post-reperfusion syndrome or vasoplegia after revascularization of the allograft. The liver function test and histological study revealed minimal hepatocyte, biliary epithelium and vascular endothelium injury during preservation and post-transplantation. The inflammatory cytokine levels were much lower in IFOT than those in conventional procedure. Key pathways involved in IRI were not activated after allograft revascularization. No rejection, or vascular or biliary complications occurred. The patient was discharged on day 18 post-transplantation. This marks the first case of IFOT in humans, offering opportunities to optimize transplant outcomes and maximize donor organ utilization. Ischemia-free liver transplantation can largely avoid ischemia-reperfusion injury in humans. See the accompanying video at .
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