Graft Protection For Liver Transplantation: Optimized Protocol And Preclinical Study

Background:Liver transplantation (LT) is a life-saving procedure for patients with end-stage liver diseases.5- Year survival rate is over 70% now. However, gap between donor graft and demand dramatically increased. Further inclusion of additional donor pool based on better protection of donor graft is needed.Method and materials:Sprague-Dawley rats were used in this preclinical study. We try to optimize the ischemic postconditioning (PostC), remote ischemia conditioning (RIC) and machine perfusion (MP) strategies for clinical practice.Results:We successfully established a novel model of RIC in rat LT. PostC and RIC both can alleviate ischemia reperfusion injury (IRI) after rat LT. PostC (10s*6) and RIC (5min*3) seems the ideal protocol to clinical practice. Besides, we established a stable MP system for use in optimizing MP conditions and demonstrated that MP is superior to SCS in terms of both the architecture and function of the liver.Conclusion:Improvement of graft protection strategy is the key for increasing donor pool. RIC (5min*3) algorithm seemed efficient to alleviate IRI of the liver graft in both functional and morphological categories, while MP is innovative preservation method for future LT practice.