Editorial
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2019; 11(3): 122-125
Published online Mar 27, 2019. doi: 10.4240/wjgs.v11.i3.122
Liver preservation prior to transplantation: Past, present, and future
Marcio F Chedid, Marcelo A Pinto, Jose Felipe G Juchem, Tomaz J M Grezzana-Filho, Cleber R P Kruel
Marcio F Chedid, Marcelo A Pinto, Jose Felipe G Juchem, Tomaz J M Grezzana-Filho, Cleber R P Kruel, Liver Transplant and Hepatobiliary Surgery Unit, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre 90035-903, Brazil
Author contributions: Chedid MF, Pinto MA, Juchem JFG, Grezzana-Filho TJM and Kruel CRP conceived the study and drafted the manuscript; all authors approved the final version of the article.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
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/
Corresponding author: Marcio F Chedid, MD, PhD, Professor, Surgeon, Liver Transplant and Hepatobiliary Surgery Unit and Graduate Program in Surgical Sciences, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre 90035-903, Brazil. marciochedid@hotmail.com
Telephone: +55-51-997721980
Received: March 1, 2019
Peer-review started: March 4, 2019
First decision: March 19, 2019
Revised: March 19, 2019
Accepted: March 20, 2019
Article in press: March 20, 2019
Published online: March 27, 2019
Abstract

Since Dr. Thomas Starzl performed the first series of successful liver transplants (LTs), important advances have been made in immunosuppression, operative techniques, and postoperative care. In 1988, Belzer’s group reported the first successful LT using the University of Wisconsin preservation solution (UW). Since then, UW has replaced EuroCollins solution and allowed prolonged and safer preservation of liver, kidney, and pancreas allografts, thus contributing to the improvement of transplant outcomes. Although UW is still considered the standard of care in the United States and in several countries worldwide, a recent meta-analysis revealed similar LT outcomes among UW, Celsior solution, and the Institut Georges Lopez-1 preservation solution, which were slightly superior to those obtained with histidine-tryptophan-ketoglutarate preservation solution. Dynamic preservation has been recently developed, and liver allografts are preserved mainly through the following methods: hypothermic machine perfusion, normothermic machine perfusion, and subnormothermic machine perfusion. Their use has the potential advantage of improving clinical results in LT involving extended criteria donor allografts. Although associated with increased costs, techniques employing machine perfusion of liver allografts have been considered clinically feasible. This editorial focuses on recent advances and future perspectives in liver allograft preservation.

Keywords: Liver transplantation, University of Wisconsin preservation solution, Institute Georges Lopez preservation solution, Celsior preservation solution, Histidine-tryptophan-ketoglutarate preservation solution, Dymamic preservation, Normothermic ischemia, Normothermic preservation, Hypotermic machine preservation, Static cold prreservation

Core tip: Important advances in immunosuppression, operative techniques, and postoperative care have been made in liver transplantation over time. The success of a transplant is largely dependent on adequate organ preservation. This editorial focuses on recent advances in the preservation of liver allografts.