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Medicina
Special Issues
New Insights on Liver Transplantation and Regeneration
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New Insights on Liver Transplantation and Regeneration

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Gastroenterology & Hepatology".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 7971

Special Issue Editors

Dr. Nicholas Gilbo

E-Mail Website
Guest Editor
Transplantation Research Group, Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium
Interests: liver transplantation; liver preservation; liver regeneration; mesenchymal stem cells; extracellular vesicles; ischemia reperfusion injury
Dr. Davide Ghinolfi

E-Mail Website
Co-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

Special Issue Information

Dear Colleagues,

In recent years, the field of liver transplantation has seen unprecedented advancements, and ground-breaking achievements can be expected soon, as the field is quickly reaching a crossroads with regenerative medicine.

The return to the clinic of dynamic liver preservation strategies has fostered further understanding of the root of hepatic ischemia–reperfusion injury, and has promoted investigations of liver function during perfusion as a means for risk stratification and post-transplant function prediction. Additionally, ex situ dynamic liver preservation supplies a unique setting to deliver therapies aimed at promoting organ regeneration or repurposing grafts that are beyond repair.

Liver transplantation represents a true therapeutic success, and so efforts are being made to expand indications and offer this curative treatment to a greater number of patients, i.e., those suffering from liver tumors other than HCC or infected with HIV. However, the impact of expanding liver transplant indications on waitlist dynamics and mortality must be carefully assessed. Meanwhile, recent ground-breaking proof of concepts showing promising short-term results after kidney and heart xenotransplantation in humans has earned the attention of news outlets, paving the road for liver xenotransplantation to expand the donor pool.

Lastly, the current COVID-19 pandemic has forced the liver transplant community worldwide to re-think donor and recipient selection, organ procurement, post-operative management, and disease prevention.

As new evidence accrues and novel research questions arise, the journal Medicina is launching a Special Issue entitled "New insights on liver transplantation and regeneration", with the aim to collect all relevant evidence and stimulate discussion on the future directions of liver transplantation and regeneration research.

This Special Issue welcomes submissions on topics including, but not limited to:

  • Mitochondrial injury and dysfunction during hepatic ischemia–reperfusion;
  • In situ and ex situ dynamic preservation;
  • Liver viability assessment and risk stratification;
  • Liver regeneration during dynamic preservation;
  • Transplant oncology;
  • Systemic therapy for HCC;
  • COVID-19;
  • Artificial intelligence;
  • Liver xenotransplantation;
  • New endpoints and trial designs.

We are pleased to invite you and your co-workers to submit either literature reviews or original research articles, highlighting the state of the art, discussing current limitations, or addressing unresolved issues in the fast-evolving field of liver transplantation and regeneration.

You may choose our Joint Special Issue in Transplantology.

Dr. Nicholas Gilbo
Dr. Davide Ghinolfi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • mitochondrial injury
  • liver machine perfusion
  • liver viability
  • liver regeneration
  • transplant oncology
  • HCC
  • COVID-19
  • artificial intelligence
  • liver xenotransplantation
  • endpoints

Published Papers (4 papers)

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Review

15 pages, 370 KiB  
Review
New Insights in the Setting of Transplant Oncology
by Silvia Quaresima, Fabio Melandro, Francesco Giovanardi, Kejal Shah, Valerio De Peppo, Gianluca Mennini, Davide Ghinolfi, Ashley Limkemann, Timothy M. Pawlik and Quirino Lai
Medicina 2023, 59(3), 568; https://doi.org/10.3390/medicina59030568 - 14 Mar 2023
Cited by 6 | Viewed by 1992
Abstract
Background and Objectives: Liver transplantation (LT) is the best strategy for curing several primary and secondary hepatic malignancies. In recent years, growing interest has been observed in the enlargement of the transplant oncology indications. This paper aims to review the most recent [...] Read more.
Background and Objectives: Liver transplantation (LT) is the best strategy for curing several primary and secondary hepatic malignancies. In recent years, growing interest has been observed in the enlargement of the transplant oncology indications. This paper aims to review the most recent developments in the setting of LT oncology, with particular attention to LT for unresectable colorectal liver metastases (CRLM) and cholangiocellular carcinoma (CCA). Materials and Methods: A review of the recently published literature was conducted. Results: Growing evidence exists on the efficacy of LT in curing CRLM and peri-hilar and intrahepatic CCA in well-selected patients when integrating this strategy with (neo)-adjuvant chemotherapy, radiotherapy, or locoregional treatments. Conclusion: For unresectable CCA and CRLM management, several prospective protocols are forthcoming to elucidate LT’s impact relative to alternative therapies. Advances in diagnosis, treatment protocols, and donor-to-recipient matching are needed to better define the oncological indications for transplantation. Prospective, multicenter trials studying these advances and their impact on outcomes are still required. Full article
(This article belongs to the Special Issue New Insights on Liver Transplantation and Regeneration)
21 pages, 640 KiB  
Review
State-of-the-Art and Future Directions in Organ Regeneration with Mesenchymal Stem Cells and Derived Products during Dynamic Liver Preservation
by Nicola De Stefano, Alberto Calleri, Victor Navarro-Tableros, Federica Rigo, Damiano Patrono and Renato Romagnoli
Medicina 2022, 58(12), 1826; https://doi.org/10.3390/medicina58121826 - 12 Dec 2022
Cited by 2 | Viewed by 1901
Abstract
Transplantation is currently the treatment of choice for end-stage liver diseases but is burdened by the shortage of donor organs. Livers from so-called extended-criteria donors represent a valid option to overcome organ shortage, but they are at risk for severe post-operative complications, especially [...] Read more.
Transplantation is currently the treatment of choice for end-stage liver diseases but is burdened by the shortage of donor organs. Livers from so-called extended-criteria donors represent a valid option to overcome organ shortage, but they are at risk for severe post-operative complications, especially when preserved with conventional static cold storage. Machine perfusion technology reduces ischemia-reperfusion injury and allows viability assessment of these organs, limiting their discard rate and improving short- and long-term outcomes after transplantation. Moreover, by keeping the graft metabolically active, the normothermic preservation technique guarantees a unique platform to administer regenerative therapies ex vivo. With their anti-inflammatory and immunomodulatory properties, mesenchymal stem cells are among the most promising sources of therapies for acute and chronic liver failure, but their routine clinical application is limited by several biosafety concerns. It is emerging that dynamic preservation and stem cell therapy may supplement each other if combined, as machine perfusion can be used to deliver stem cells to highly injured grafts, avoiding potential systemic side effects. The aim of this narrative review is to provide a comprehensive overview on liver preservation techniques and mesenchymal stem cell-based therapies, focusing on their application in liver graft reconditioning. Full article
(This article belongs to the Special Issue New Insights on Liver Transplantation and Regeneration)
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Graphical abstract

11 pages, 1834 KiB  
Review
Crossroads in Liver Transplantation: Is Artificial Intelligence the Key to Donor–Recipient Matching?
by Rafael Calleja Lozano, César Hervás Martínez and Francisco Javier Briceño Delgado
Medicina 2022, 58(12), 1743; https://doi.org/10.3390/medicina58121743 - 28 Nov 2022
Cited by 3 | Viewed by 1586
Abstract
Liver transplantation outcomes have improved in recent years. However, with the emergence of expanded donor criteria, tools to better assist donor–recipient matching have become necessary. Most of the currently proposed scores based on conventional biostatistics are not good classifiers of a problem that [...] Read more.
Liver transplantation outcomes have improved in recent years. However, with the emergence of expanded donor criteria, tools to better assist donor–recipient matching have become necessary. Most of the currently proposed scores based on conventional biostatistics are not good classifiers of a problem that is considered “unbalanced.” In recent years, the implementation of artificial intelligence in medicine has experienced exponential growth. Deep learning, a branch of artificial intelligence, may be the answer to this classification problem. The ability to handle a large number of variables with speed, objectivity, and multi-objective analysis is one of its advantages. Artificial neural networks and random forests have been the most widely used deep classifiers in this field. This review aims to give a brief overview of D–R matching and its evolution in recent years and how artificial intelligence may be able to provide a solution. Full article
(This article belongs to the Special Issue New Insights on Liver Transplantation and Regeneration)
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13 pages, 649 KiB  
Review
Viability Criteria during Liver Ex-Situ Normothermic and Hypothermic Perfusion
by Fabio Melandro, Riccardo De Carlis, Francesco Torri, Andrea Lauterio, Paolo De Simone, Luciano De Carlis and Davide Ghinolfi
Medicina 2022, 58(10), 1434; https://doi.org/10.3390/medicina58101434 - 11 Oct 2022
Cited by 7 | Viewed by 1755
Abstract
With the increased use of extended-criteria donors, machine perfusion became a beneficial alternative to cold storage in preservation strategy for donor livers with the intent to expand donor pool. Both normothermic and hypothermic approach achieved good results in terms of mid- and long-term [...] Read more.
With the increased use of extended-criteria donors, machine perfusion became a beneficial alternative to cold storage in preservation strategy for donor livers with the intent to expand donor pool. Both normothermic and hypothermic approach achieved good results in terms of mid- and long-term outcome in liver transplantation. Many markers and molecules have been proposed for the assessment of liver, but no definitive criteria for graft viability have been validated in large clinical trials and key parameters during perfusion still require optimization.In this review, we address the current literature of viability criteria during normothermic and hypothermic machine perfusion and discuss about future steps and evolution of these technologies. Full article
(This article belongs to the Special Issue New Insights on Liver Transplantation and Regeneration)
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