The preservation of livers to be transplanted is currently obtained by static cold storage at 4 C degrees and flushing with UW solution. New methods of preservation are being studied that take advantage of machines for continuous hypothermic perfusion of the organ. Such machines have permitted a lengthening of preservation times and the use of livers from non-beating-heart donors. In an attempt to eliminate the damage due to hypothermia, to lengthen preservation times, and to extend the availability of livers to be transplanted, also using those subjected to short periods of warm ischaemia, we have constructed a transportable machine that produces a hyperbaric atmosphere and allows continuous perfusion of the liver. Ten pig livers from beating-heart donors were perfused with Ringer solution in hyperbaric conditions with oxygen at temperatures ranging from 10 to 25 degrees C for periods of up to 24 hours and studied by means of histopathological analysis and tests of mitochondrial activity (FAU) in order to verify cell viability. The group of livers perfused up to 15 hours yielded an FAU value of 169.40 +/- 5.5 compared to the value of the non-perfused livers (controls) established as 100 and those perfused up to 24 hours had a FAU value of 139.18 +/- 10.7 compared to the controls established as 100, thus demonstrating cell viability. The viability of the organs after preservation with our procedure in the hyperbaric oxygenation perfusion machine gives us good reason to believe that, after appropriate further confirmation of the results, it will be possible to use the machine for the transplantation both of livers subjected to warm ischaemia and of livers preserved for longer periods than is currently the case.
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Eur J Nucl Med Mol Imaging
January 2025
Department of Hepatobiliary Surgery and Liver Transplantation Center, The Fifth Affiliated Hospital of Sun Yat-Sen University, 52 Mei Hua East Road, Zhuhai, 519000, China.
Purpose: Cancer-associated fibroblasts (CAFs) are the primary stromal component of the tumor microenvironment in hepatocellular carcinoma (HCC), affecting tumor progression and post-resection recurrence. Fibroblast activation protein (FAP) is a key biomarker of CAFs. However, there is limited evidence on using FAP as a target in near-infrared (NIR) fluorescence imaging for HCC.
View Article and Find Full Text PDFLiver Transpl
January 2025
Hepato-biliary-pancreatic Surgery and Liver Transplantation Unit, Padua University Hospital, Padua, Italy.
Total hepatectomy and liver transplantation has emerged as a game-changing strategy in the treatment of several liver-confined primary or metastatic tumors, opening the new era of transplant oncology. However, the expansion of indications is going to worsen the chronic scarcity of organs, and new strategies are needed to enlarge the donor pool. A possible source of organs could be developing split liver transplantation (SLT) programs.
View Article and Find Full Text PDFClin Transl Gastroenterol
January 2025
Division of Gastroenterology and Liver Diseases, University of Southern California, Los Angeles, California.
Introduction: "Healthcare contact days" is a patient-centered quantitative proxy for time toxicity, which can be informative for liver transplant (LT) decision-making. We aimed to (i) quantify contact days in patients with cirrhosis pre- and post-LT; (ii) identify clinical and demographic features associated with contact days.
Methods: Using a national health system database, we calculated healthcare contact days (inpatient, outpatient hospital [e.
Clin Transl Gastroenterol
January 2025
Bausch Health, Bridgewater, NJ, USA.
Objectives: Describing cirrhosis and hepatic encephalopathy (HE) burden over time can inform clinical management and resource allocation. Using health care claims data, this observational study examined recent trends in the prevalence of cirrhosis and HE and associated health care resource utilization among commercially and Medicare-insured adults in the United States (US).
Methods: Data from the MarketScan Commercial Claims and Encounters Database and 100% Medicare Research Identifiable Files were analyzed (2007-2020).
Front Transplant
January 2025
Department of Surgical, Medical, Biomolecular Pathology and Intensive Care, University of Pisa, Pisa, Italy.
Background And Aims: There is growing interest in the environmental impact of surgical procedures, yet more information is needed specifically regarding liver transplantation. This study aims to quantify the total greenhouse gas emissions, or carbon footprint, associated with adult whole-size liver transplantation from donors after brain death, including the relevant back-table graft preparation.
Methods: The carbon footprint was calculated retrospectively using a bottom-up approach.
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