Molecular Mechanism of Liver Transplantation

Dear Colleagues,

A major challenge in the liver transplantation (LT) field is the insufficient number of donors compared with the growing demand of transplant candidates. Thus, it is necessary to develop appropriate strategies that aim to favor donor/receptor selection, allocation, and organ preservation; these are topics that will contribute to improving the number and outcomes of liver transplantation. The use of living donors, donation after circulatory death (DCD), and pathological livers from donors after brain death (DBD) represent important means of expanding the donor pool. One critical, unresolved issue in LT is the use of livers with nonalcoholic fatty liver disease due their poor tolerance of the deleterious effects induced by ischemia-reperfusion injury (IRI). Accordingly, transplanted livers with nonalcoholic fatty liver disease more frequently exhibit different clinical manifestations of graft dysfunction, graft rejection, and other post-transplant complications compared with healthy livers, leading to increased morbidity and mortality of patients. The molecular mechanisms underlying their harmful effects remain to be elucidated. Some studies describe the effects of the different phases, namely DBD, DCD, the cold ischemia phase, regenerative failure, and liver damage, due to reperfused–sterile inflammation organization. Strategies to make grafts with nonalcoholic fatty liver disease safe for transplant can broadly be divided into those related to reducing the initial cold ischemic hit and those related to recovery, rehabilitation, and organ optimization in the ex situ environment, such as normothermic machine perfusion (NMP) platforms. In conclusion, the aim of this Special Issue is to contribute to this field (based on ex vivo and in vivo experimental models of LT and molecular studies) with the identification of new mechanisms and benchmarks of scientific and clinical interest to improve post-operative outcomes and reduce the waiting list for LT. 

Dr. Carmen Peralta
Dr. Juan Carlos Cutrin
Guest Editors

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• liver transplantation
• ischemia-reperfusion injury
• signaling pathways
• graft dysfunction
• sterile inflammation
• liver regeneration
• fatty grafts
• normothermic machine perfusion
• defatting strategies