Advances in the management of the explanted donor liver

Abstract

Liver transplantation is the best therapy in end-stage liver disease. Donor organ shortage and efforts to expand the donor organ pool are permanent issues given that advances in perioperative management and immunosuppressive therapy have brought the procedure into widespread clinical use. The management of organ procurement, including donor preconditioning and adequate organ storage, has a key role in transplantation. However, the organ procurement process can differ substantially between transplant centres, depending on local and national preferences. Advances in the field have come from experimental and clinical research on dynamic storage systems, such as machine perfusion devices, as an alternative to static cold storage. Determination of the clinical significance of these new systems is a topic worthy of future investigations.

The release of microRNA‐122 during liver preservation is associated with early allograft dysfunction and graft survival after transplantation

“…However, because of the growing demand for liver grafts, allografts which do not meet the traditional criteria for transplantation (ECDs, EAD) are used more frequently . In order to improve the quality of these EAD grafts and to reduce the posttransplantation risks for the receiver, machine perfusion as a preservation technique has received increasing attention . Machine preservation may also provide new opportunities to assess graft quality during the preservation period prior to transplantation and aid in the decision making of whether to transplant the organ .…”

“…In order to improve the quality of these EAD grafts and to reduce the posttransplantation risks for the receiver, machine perfusion as a preservation technique has received increasing attention . Machine preservation may also provide new opportunities to assess graft quality during the preservation period prior to transplantation and aid in the decision making of whether to transplant the organ . Reliable parameters or biomarkers for functional assessment of livers during preservation in either machine perfusion or static cold storage are of paramount importance yet are relatively unexplored …”

Noncoding RNAs and Their Potential Therapeutic Applications in Tissue Engineering

“…Survival rates have improved substantially in recent years through advances in critical-care management and the use of liver transplantation. Unfortunately, the number of available liver grafts does not meet the continuously growing need [203,204]. The use of bioengineered livers, instead of procuring organs from brain-dead donors or removing parts of the liver from living donors, is the most promising approach for liver support [205].…”

MicroRNAs in liver tissue engineering — New promises for failing organs

“…Acute or acute-on-chronic failure of the liver results in a life-threatening situation, and liver transplantation often remains the only chance to rescue the patient [1,2]. Unfortunately, the number of available liver grafts does not meet the continuously growing need, resulting in an increased number of patients who are dying while waiting for a liver transplant [3,4]. Various strategies have been developed to overcome this situation.…”

“…Strategies to improve such non-optimal organs imply donor pretreatments and ex vivo perfusion techniques to rescue Advanced Drug Delivery Reviews 88 (2015) [67][68][69][70][71][72][73][74][75][76][77] ☆ This review is part of the Advanced Drug Delivery Reviews theme issue on "MicroRNAs in tissue engineering and regenerative medicine". the diseased organs [3,[5][6][7]. On the other hand, tissue-engineered solutions have been developed and are under development to temporarily or definitively support or replace the diseased liver.…”