New therapeutic concepts against ischemia-reperfusion injury in organ transplantation

Dery, Kenneth J.; Yao, Siyuan; Cheng, Brian; Kupiec-Weglinski, Jerzy W.

doi:10.1080/1744666x.2023.2240516

Cited by 6 publications

(5 citation statements)

References 190 publications

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“…[4,31,32] One of the persistent problems that was associated with use of extended criteria donation was that the graft are susceptible to ischemic reperfusion injury which resulted in increased risk of early allograft dysfunction and primary non function. [33][34][35] These complications predispose the recipients to increased risk of sepsis, increased risk of graft loss and longer stay in the intensive care unit and longer hospital stay. [18] One of the main aims of machine perfusion is to reduce ischemic reperfusion injury and by extension reduces the risk of early allograft dysfunction and its complication.…”

Section: Discussionmentioning

confidence: 99%

Early outcome of machine perfusion vs static cold storage of liver graft: A systemic review and meta-analysis of randomized controlled trials

Umar Garzali

2024

Hepatology Forum

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Early outcomes of machine perfusion vs static cold storage of liver graft: A systemic review and meta-analysis of randomized controlled trialsBackground and aim: The use of marginal grafts is very challenging and it is associated with post reperfusion syndrome and early allograft dysfunction. The outcomes of machine perfusion for preservation of marginal graft has been compared with that of static cold storage with studies reporting reduced risk of ischemic cholangiopathy and graft loss. We perform this systematic review and meta-analysis of randomized controlled trials (RCTs) comparing outcomes of machine perfusion of liver graft compared to static cold storage (SCS) of liver graft during liver transplantation. Materials and methods: Two independent researchers thoroughly searched for literature in the following databases: PubMed (Medline), Cochrane Central Register of Controlled Studies (CENTRAL), clinical trial registry, research gate, google scholar and Scopus (ELSEVIER)databases (last search: November 2023). The search terms used were: "dynamic perfusion", "normothermic perfusion", "hypothermic perfusion", "liver transplantation", "static cold storage", "NMP", "HOPE", "extended criteria grafts", "Marginal grafts", "RCTs", "Randomized controlled trials", "warm ischemia" and "cold ischemia".Results: Eight RCTs published between 2019 to 2023 were included in the data synthesis and meta-analysis. The primary outcome we considered was overall incidence of early allograft dysfunction (EAD) between the two methods of graft perfusion after liver transplantation. The secondary outcome considered was rate of retransplantation. Our meta-analysis revealed that SCS is associated with more EAD when compared with machine perfusion with a P value of <0.00001. We also found that the rate of retransplantation is higher among patients that received liver that was preserved by SCS with a P value of 0.02. Conclusion:The use of machine perfusion in preservation of liver graft showed significant reduction in early allograft dysfunction and retransplantation.

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Section: Discussionmentioning

confidence: 99%

Early outcome of machine perfusion vs static cold storage of liver graft: A systemic review and meta-analysis of randomized controlled trials

Umar Garzali

2024

Hepatology Forum

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“…As a result, additional strategies should be implemented to counteract any possible negative impacts of nighttime surgeries in the field of transplant medicine. Among the most promising approaches is machine perfusion, which could potentially extend organ preservation times beyond the capabilities of traditional static cold storage and help reduce and improve the impacts of IRI [65]. In the realm of kidney and liver transplants, employing this technique to perfuse "marginal organs" aims to enhance organ utilization rates from marginal donors with acceptable outcomes, thus expanding the pool of viable donor organs [66][67][68].…”

Section: Discussionmentioning

confidence: 99%

Does Timepoint of Surgical Procedure Affect the Outcome in Simultaneous Pancreas–Kidney Transplantation? A Retrospective Single-Center Analysis over 20 Years

Hau,

Jahn,

Vlachos

et al. 2024

JCM

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Background: Sleep deprivation and disturbances in circadian rhythms may hinder surgical performance and decision-making capabilities. Solid organ transplantations, which are technically demanding and often begin at uncertain times, frequently during nighttime hours, are particularly susceptible to these effects. This study aimed to assess how transplant operations conducted during daytime versus nighttime influence both patient and graft outcomes and function. Methods: simultaneous pancreas–kidney transplants (SPKTs) conducted at the University Hospital of Leipzig from 1998 to 2018 were reviewed retrospectively. The transplants were categorized based on whether they began during daytime hours (8 a.m. to 6 p.m.) or nighttime hours (6 p.m. to 8 a.m.). We analyzed the demographics of both donors and recipients, as well as primary outcomes, which included surgical complications, patient survival, and graft longevity. Results: In this research involving 105 patients, 43 SPKTs, accounting for 41%, took place in the daytime, while 62 transplants (59%) occurred at night. The characteristics of both donors and recipients were similar across the two groups. Further, the rate of (surgical) pancreas graft-related complications and reoperations (daytime 39.5% versus nighttime 33.9%; p = 0.552) were also not statistically significant between both groups. In this study, the five-year survival rate for patients was comparable for both daytime and nighttime surgeries, with 85.2% for daytime and 86% for nighttime procedures (p = 0.816). Similarly, the survival rates for pancreas grafts were 75% for daytime and 77% for nighttime operations (p = 0.912), and for kidney grafts, 76% during the day compared to 80% at night (p = 0.740), indicating no significant statistical difference between the two time periods. In a multivariable model, recipient BMI > 30 kg/m2, donor age, donor BMI, and cold ischemia time > 15 h were independent predictors for increased risk of (surgical) pancreas graft-related complications, whereas the timepoint of SPKT (daytime versus nighttime) did not have an impact. Conclusions: The findings from our retrospective analysis at a big single German transplant center indicate that SPKT is a reliable procedure, regardless of the start time. Additionally, our data revealed that patients undergoing nighttime transplants have no greater risk of surgical complications or inferior results concerning long-term survival of the patient and graft. However, due to the small number of cases evaluated, further studies are required to confirm these results.

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“… 19 , 20 Ischemia‒reperfusion injury can be divided into two types: “warm” ischemia‒reperfusion injury and “cold” ischemia‒reperfusion injury. 21 , 22 , 23 Warm ischemia‒reperfusion injury triggered by hepatocyte injury occurs during liver transplantation surgery or during various forms of shock or trauma and may lead to liver and even multiple organ failure. 22 Cold ischemia‒reperfusion injury caused by hepatic sinusoidal endothelial cell injury and microcirculation damage occurs in the process of in vitro preservation and is usually accompanied by warm ischemia‒reperfusion injury during liver transplantation surgery.…”

Section: Discussionmentioning

confidence: 99%

Pim-1 kinase protects the liver from ischemia reperfusion injury by regulating dynamics-related protein 1

Sun,

Xu,

Dai

et al. 2024

iScience

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New therapeutic concepts against ischemia-reperfusion injury in organ transplantation

Cited by 6 publications

References 190 publications

Early outcome of machine perfusion vs static cold storage of liver graft: A systemic review and meta-analysis of randomized controlled trials

Early outcome of machine perfusion vs static cold storage of liver graft: A systemic review and meta-analysis of randomized controlled trials

Does Timepoint of Surgical Procedure Affect the Outcome in Simultaneous Pancreas–Kidney Transplantation? A Retrospective Single-Center Analysis over 20 Years

Pim-1 kinase protects the liver from ischemia reperfusion injury by regulating dynamics-related protein 1

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