Long-term normothermic machine perfusion of fatty livers:towards transplanting untransplantable livers?  

作　　者：Damiano Patrono Nicola De Stefano Elena Vissio Alessandro Gambella Renato Romagnoli 

机构地区：[1]General Surgery 2U–Liver Transplant Unit,Azienda Ospedaliero Universitaria Cittàdella Salute e della Scienza di Torino,Turin,Italy [2]Pathology Unit,Azienda Ospedaliero Universitaria Cittàdella Salute e della Scienza di Torino,Turin,Italy [3]Department of Medical Sciences,University of Turin,Turin,Italy

出　　处：《Hepatobiliary Surgery and Nutrition》2024年第4期681-685,共5页肝胆外科与营养（英文）

摘　　要：Since the very early days of clinical liver transplantation(LT),transplant surgeons and professionals have been confronted with the increased risk of failure associated with the use of fatty liver grafts(1).Notwithstanding the wide variability in steatosis assessment across different centers and pathologists(2),utilization of livers with moderate(≥30%)or severe(≥60%)macrovesicular steatosis has been consistently associated with an increased risk of primary non-function,early allograft dysfunction,acute kidney injury,as well as inferior graft and patient survival(3).The mechanisms behind the increased susceptibility of steatotic livers to ischemia-reperfusion injury(IRI)are multiple,including disturbances to microcirculation due to sinusoidal narrowing,increased oxidative stress upon reperfusion and enhanced lipid peroxidation,leading to an increased release of inflammatory mediators like IL6,IL1βand so-called damage associated molecular patterns(DAMP),like cell-free DNA and mitochondrial DNA.Histologically,this is reflected by hepatocyte death by necrosis rather than apoptosis,pseudopeliotic steatosis(i.e.,the expulsion of lipid droplets into the extracellular space)and lately,by tissue remodelling and fibrosis(4,5).

关 键 词：Liver transplantation(LT) STEATOSIS macrovesicular steatosis large droplet fat normothermic machine perfusion 

分 类 号：R657.3[医药卫生—外科学]