Ischemia-free liver transplantation improves the prognosis of recipients using functionally marginal liver grafts

• DOI: 10.3350/cmh.2024.0139
• Publication Date: 2024-04-11T07:46:11Z
• Authors: Shuai Wang; Xiaohong Lin; Yunhua Tang; Yichen Liang; Min Zhang; Zhonghao Xie; Yiwen Guo; Yuqi Dong; Qiang Zhao; Zhiyong Guo; Dongping Wang; Xiaoshun He; Weiqiang Ju; Maogen Chen
• Keywords: 0301 basic medicine; marginal liver grafts; 03 medical and health sciences; liver transplantation; normothermic machine perfusion; Original Article; RC799-869; Diseases of the digestive system. Gastroenterology; ischemia-free liver transplantation; transplantation immunology; static cold storage

Background/Aims: The shortage of donor liver hinders the development transplantation. This study aimed to clarify poor outcomes functionally marginal grafts (FMLs) and provide evidence for improvement ischemia-free transplantation (IFLT) after FML transplantation.Methods: Propensity score matching was used control confounding factors. group were compared demonstrate negative impact FMLs on patients. We clinical improvements different surgical types. To elucidate underlying mechanism, we conducted bioinformatic analysis based transcriptome single-cell profiles.Results: had a significantly greater hazard ratio (HR: 1.969, P=0.018) than did other livers. A worse 90-day survival (Mortality: 12.3% vs. 5.0%, P=0.007) observed in patients who underwent Patients received significant overall IFLT 10.4% vs 31.3%, P=0.006). Pyroptosis inflammation inhibited IFLT. infiltration natural killer cells lower from these Bulk profiles revealed positive relationship between IL-32 Caspase 1 (R=0.73, P=0.01) Gasdermin D (R=0.84, P=0.0012).Conclusions: is more important prognostic parameter parameters. might ameliorate injury by inhibiting NK cells, consequently leading abortion IL-32, which drives pyroptosis monocytes macrophages.