Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2015; 21(2): 396-407
Published online Jan 14, 2015. doi: 10.3748/wjg.v21.i2.396
Emerging concepts in liver graft preservation
Mohamed Bejaoui, Eirini Pantazi, Emma Folch-Puy, Pedro M Baptista, Agustín García-Gil, René Adam, Joan Roselló-Catafau
Mohamed Bejaoui, Eirini Pantazi, Emma Folch-Puy, Joan Roselló-Catafau, Experimental Hepatic Ischemia-Reperfusion Unit, Institute of Biomedical Research of Barcelona-Spanish National Research Council, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, 08036 Barcelona, Catalonia, Spain
Pedro M Baptista, Agustín García-Gil, Universidad de Zaragoza, CIBER- ehd, Aragon Health Sciences Institute, 50009 Zaragoza, Spain
René Adam, AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, Université Paris-Sud Villejuif, 75008 Paris, France
Author contributions: Bejaoui M, Pantazi E, Folch-Puy E and Baptista PM wrote the static preservation, graft washout, dynamic preservation and medicine regenerative sections respectively. García-Gil A, Roselló-Catafau J and Adam R designed and wrote the paper; all authors have read and approved the final manuscript.
Supported by Grant from Fondo de Investigaciones Sanitarias, No. FIS PI12/00519; Eirini Pantazi is the recipient of a fellowship from Agència de Gestió d’Ajuts Universitaris i de Recerca, No. 2012FI_B00382), Generalitat de Catalunya, Barcelona, Spain.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Joan Roselló-Catafau, PhD, Experimental Hepatic Ischemia-Reperfusion Unit, Institute of Biomedical Research of Barcelona-Spanish National Research Council, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, C/Rosselló 161, 7th floor, 08036 Barcelona, Catalonia, Spain. jrcbam@iibb.csic.es
Telephone: +34-933-638300 Fax: +34-933-638301
Received: August 28, 2014
Peer-review started: August 31, 2014
First decision: September 27, 2014
Revised: October 24, 2014
Accepted: December 8, 2014
Article in press: December 8, 2014
Published online: January 14, 2015
Abstract

The urgent need to expand the donor pool in order to attend to the growing demand for liver transplantation has obliged physicians to consider the use of suboptimal liver grafts and also to redefine the preservation strategies. This review examines the different methods of liver graft preservation, focusing on the latest advances in both static cold storage and machine perfusion (MP). The new strategies for static cold storage are mainly designed to increase the fatty liver graft preservation via the supplementation of commercial organ preservation solutions with additives. In this paper we stress the importance of carrying out effective graft washout after static cold preservation, and present a detailed discussion of the future perspectives for dynamic graft preservation using MP at different temperatures (hypothermia at 4 °C, normothermia at 37 °C and subnormothermia at 20 °C-25 °C). Finally, we highlight some emerging applications of regenerative medicine in liver graft preservation. In conclusion, this review discusses the “state of the art” and future perspectives in static and dynamic liver graft preservation in order to improve graft viability.

Keywords: Static cold preservation, Suboptimal liver grafts, Preservation solutions, Graft washout solutions, Machine perfusion and liver bioengineering

Core tip: This review focuses on the latest advances in liver graft preservation, in both static cold storage and dynamic preservation by machine perfusion (MP). We describe some new trends for static cold preservation based on our experience; we stress the importance of developing washout solutions and the use of MP for suboptimal liver grafts. Finally, we discuss emerging applications of regenerative medicine in liver graft preservation.