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Mitochondrial Reprogramming—What Is the Benefit of Hypothermic Oxygenated Perfusion in Liver Transplantation?

1
Hepatobiliary Unit, Careggi University Hospital, University of Florence, 50134 Florence, Italy
2
General Surgery 2U-Liver Transplant Unit, Department of Surgery, A.O.U. Città della Salute e della Scienza di Torino, University of Turin, 10124 Turin, Italy
3
Swiss HPB and Transplant Center, Department of Visceral Surgery and Transplantation, University Hospital Zurich, 8091 Zurich, Switzerland
*
Author to whom correspondence should be addressed.
Academic Editors: Constança Figueiredo and Yasuhiko Sugawara
Transplantology 2021, 2(2), 149-161; https://doi.org/10.3390/transplantology2020015
Received: 9 March 2021 / Revised: 25 March 2021 / Accepted: 27 April 2021 / Published: 12 May 2021
Although machine perfusion is a hot topic today, we are just at the beginning of understanding the underlying mechanisms of protection. Recently, the first randomized controlled trial reported a significant reduction of ischemic cholangiopathies after transplantation of livers donated after circulatory death, provided the grafts were treated with an endischemic hypothermic oxygenated perfusion (HOPE). This approach has been known for more than fifty years, and was initially mainly used to preserve kidneys before implantation. Today there is an increasing interest in this and other dynamic preservation technologies and various centers have tested different approaches in clinical trials and cohort studies. Based on this, there is a need for uniform perfusion settings (perfusion route and duration), and the development of general guidelines regarding the duration of cold storage in context of the overall donor risk is also required to better compare various trial results. This article will highlight how cold perfusion protects organs mechanistically, and target such technical challenges with the perfusion setting. Finally, the options for viability testing during hypothermic perfusion will be discussed. View Full-Text
Keywords: liver transplantation; hypothermic oxygenated perfusion; mitochondrial reprogramming; biliary tree liver transplantation; hypothermic oxygenated perfusion; mitochondrial reprogramming; biliary tree
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MDPI and ACS Style

Panconesi, R.; Flores Carvalho, M.; Mueller, M.; Dutkowski, P.; Muiesan, P.; Schlegel, A. Mitochondrial Reprogramming—What Is the Benefit of Hypothermic Oxygenated Perfusion in Liver Transplantation? Transplantology 2021, 2, 149-161. https://doi.org/10.3390/transplantology2020015

AMA Style

Panconesi R, Flores Carvalho M, Mueller M, Dutkowski P, Muiesan P, Schlegel A. Mitochondrial Reprogramming—What Is the Benefit of Hypothermic Oxygenated Perfusion in Liver Transplantation? Transplantology. 2021; 2(2):149-161. https://doi.org/10.3390/transplantology2020015

Chicago/Turabian Style

Panconesi, Rebecca, Mauricio Flores Carvalho, Matteo Mueller, Philipp Dutkowski, Paolo Muiesan, and Andrea Schlegel. 2021. "Mitochondrial Reprogramming—What Is the Benefit of Hypothermic Oxygenated Perfusion in Liver Transplantation?" Transplantology 2, no. 2: 149-161. https://doi.org/10.3390/transplantology2020015

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