Donor Simvastatin Treatment in Liver Transplantation: Post Hoc Analysis of a Randomized Placebo-controlled Trial With Long-term Follow-up

Comment to “Donor Simvastatin Treatment in Liver Transplantation: Post-hoc Analysis of a Randomized Placebo-controlled Trial With Long-term Follow-up”

“…I n their letter, the authors draw attention to the longterm liver transplant results in liver transplantation (LT) outcomes of patients included in the Donor Simvastatin Treatment in Organ Transplantation (SIMVA) trial, focusing on the clinical benefit of donor simvastatin in cases with cold ischemia times <270-300 min in a median post-LT follow-up of 6.8 y (range 0-11 y). 1 Although there is significant heterogeneity in when and how to implement such treatments, it is increasingly clear (both in the experimental and clinical settings) that pharmacological treatments or surgical perfusion techniques may be applied to mitigate the effects of the damage caused by ischemia/ reperfusion. 2 The statin pleiotropic effects are able to influence oxidative stress, proinflammatory cytokine signaling, and mitochondria-mediated mechanisms' activation, both involved in the complex and not fully understood ischemia/reperfusion processes that begin in the ischemic phase and intensify during reperfusion.…”