Transformative Technologies in Liver Transplantation

A special issue of Life (ISSN 2075-1729).

Deadline for manuscript submissions: 30 June 2026 | Viewed by 954

Special Issue Editors


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Guest Editor
Division of Hepatic Surgery and Liver Transplantation, University of Pisa Hospital, Pisa, Italy
Interests: liver transplantation; machine perfusion; organ therapeutics; extended criteria grafts; ischemia reperfusion injury
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Division of Hepatic Surgery and Liver Transplantation, Azienda Ospedaliera Universitaria Pisana, 56124 Pisa, Italy
Interests: liver transplantation; multiorgan donors; perfusion machines; HPB surgery; minimally invasive liver surgery; new technologies and advances in liver transplantation and HPB surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Organ transplantation is undergoing a significant transformation, driven by the rapid advancement of innovative technologies aimed at improving both short- and long-term outcomes. From organ preservation and allocation to surgical planning, post-operative monitoring, and immunomodulation, emerging tools are redefining the entire transplant care continuum.

Technologies such as artificial intelligence, machine perfusion, 3D printing, wearable sensors, gene editing, and telemedicine are opening new frontiers in transplant medicine. These developments not only enhance the precision and safety of surgical procedures but also enable more personalized and predictive approaches to patient management.

In this Special Issue, leading researchers and clinicians will present state-of-the-art technologies applied across different domains of transplantation. The focus will be on how these innovations are reshaping current practices, improving organ utilization, and enabling novel therapeutic strategies.

This issue aims to highlight the clinical relevance, translational potential, and multidisciplinary impact of transformative technologies in transplantation.

Dr. Davide Ghinolfi
Dr. Lorenzo Petagna
Guest Editors

Dr. Giulia Cirillo
Dr. Arianna Trizzino
Guest Editor Assistants

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Keywords

  • liver
  • transplant
  • liver surgery
  • machine perfusion
  • radiomics
  • nanotechnology
  • 3D printing
  • gene editing

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Published Papers (1 paper)

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Research

22 pages, 2221 KB  
Article
Cytokines Adsorption During Ex Situ Machine Perfusion of Liver Grafts from Elderly Donors: A Pilot, Prospective, Randomized Study
by Giulia Cirillo, Lorenzo Bernardi, Daniele Pezzati, Maria Franzini, Emanuele Balzano, Giovanni Tincani, Jessica Bronzoni, Caterina Martinelli, Arianna Trizzino, Lorenzo Petagna, Paola Carrai, Stefania Petruccelli, Ranka Vukotic, Erlis Uruci, Matilde Masini, Serena Babboni, Serena Del Turco, Riccardo Morganti, Vincenzo De Tata, Aldo Paolicchi, Giandomenico Biancofiore, Adriano Peris, Chiara Lazzeri, Giuseppina Basta and Davide Ghinolfiadd Show full author list remove Hide full author list
Life 2026, 16(1), 167; https://doi.org/10.3390/life16010167 - 20 Jan 2026
Cited by 1 | Viewed by 618
Abstract
Ischemia–reperfusion injury (IRI) is a mechanism based on inflammatory mediators’ release and activation of effectors of damage. Studies showed a correlation between cytokine, severity of damage, and post-operative outcomes. Ex situ perfusion may work as a platform for the treatment of IRI mechanisms, [...] Read more.
Ischemia–reperfusion injury (IRI) is a mechanism based on inflammatory mediators’ release and activation of effectors of damage. Studies showed a correlation between cytokine, severity of damage, and post-operative outcomes. Ex situ perfusion may work as a platform for the treatment of IRI mechanisms, such as the removal of cytokines using cytokine adsorption (CA). We assessed the safety and benefits of an integrated CA during ex situ dual-oxygenated hypothermic (D-HOPE) and normothermic perfusion (NMP). During the period of July 2021–December 2023, 84 octogenarian liver grafts, suitable for transplantation, were considered: 12 were randomized to D-HOPE or NMP with or without CA (D-HOPE + CA, D-HOPE, NMP + CA, NMP groups, n = 3 each) and compared to 72 performed using grafts preserved in static cold storage (SCS). IL-1, IL-6, IL-10, and TNF-a perfusate concentrations were evaluated together with perfusion parameters and post-operative outcomes. Perfusion procedures were unaffected by CA integration. In NMP, cytokine levels were 10–40 times higher than in healthy subjects and 20–50 times higher than D-HOPE. Cytokines were removed both in D-HOPE and NMP, but the concentration-dependent mechanisms of action of CA led to more remarkable removal in NMP. IL-10 and TNF-a concentrations were significantly lower in NMP + CA than in NMP. The application of CA was associated with significantly higher arterial flows both in D-HOPE and NMP, and reduced neutrophil infiltration in NMP. No differences in post-operative outcomes were found among groups. In conclusion, cytokine adsorption during ex situ machine perfusion of liver grafts from elderly donors is safe and feasible and is associated with modulation of inflammatory mediators and perfusion dynamics. These findings are hypothesis-generating, and larger studies are required to determine the clinical impact of this strategy. Full article
(This article belongs to the Special Issue Transformative Technologies in Liver Transplantation)
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