Mitochondria and Cancer Recurrence after Liver Transplantation—What Is the Benefit of Machine Perfusion?
Tumor recurrence after liver transplantation has been linked to multiple factors, including the recipient’s tumor burden, donor factors, and ischemia-reperfusion injury (IRI). The increasing number of livers accepted from extended criteria donors has forced the transplant community to push the devel...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/23/17/9747 |
| _version_ | 1797495228304719872 |
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| author | Alessandro Parente Mauricio Flores Carvalho Janina Eden Philipp Dutkowski Andrea Schlegel |
| author_facet | Alessandro Parente Mauricio Flores Carvalho Janina Eden Philipp Dutkowski Andrea Schlegel |
| author_sort | Alessandro Parente |
| collection | DOAJ |
| description | Tumor recurrence after liver transplantation has been linked to multiple factors, including the recipient’s tumor burden, donor factors, and ischemia-reperfusion injury (IRI). The increasing number of livers accepted from extended criteria donors has forced the transplant community to push the development of dynamic perfusion strategies. The reason behind this progress is the urgent need to reduce the clinical consequences of IRI. Two concepts appear most beneficial and include either the avoidance of ischemia, e.g., the replacement of cold storage by machine perfusion, or secondly, an endischemic organ improvement through perfusion in the recipient center prior to implantation. While several concepts, including normothermic perfusion, were found to reduce recipient transaminase levels and early allograft dysfunction, hypothermic oxygenated perfusion also reduced IRI-associated post-transplant complications and costs. With the impact on mitochondrial injury and subsequent less IRI-inflammation, this endischemic perfusion was also found to reduce the recurrence of hepatocellular carcinoma after liver transplantation. Firstly, this article highlights the contributing factors to tumor recurrence, including the surgical and medical tissue trauma and underlying mechanisms of IRI-associated inflammation. Secondly, it focuses on the role of mitochondria and associated interventions to reduce cancer recurrence. Finally, the role of machine perfusion technology as a delivery tool and as an individual treatment is discussed together with the currently available clinical studies. |
| first_indexed | 2024-03-10T01:44:49Z |
| format | Article |
| id | doaj.art-09d66c0f729742869f0cf8dcee1a7faf |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-10T01:44:49Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-09d66c0f729742869f0cf8dcee1a7faf2023-11-23T13:16:16ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672022-08-012317974710.3390/ijms23179747Mitochondria and Cancer Recurrence after Liver Transplantation—What Is the Benefit of Machine Perfusion?Alessandro Parente0Mauricio Flores Carvalho1Janina Eden2Philipp Dutkowski3Andrea Schlegel4The Liver Unit, Queen Elizabeth University Hospital Birmingham, Birmingham B15 2GW, UKFondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Centre of Preclinical Research, 20122 Milan, ItalyDepartment of Surgery and Transplantation, Swiss HPB Centre, University Hospital Zurich, 8091 Zurich, SwitzerlandDepartment of Surgery and Transplantation, Swiss HPB Centre, University Hospital Zurich, 8091 Zurich, SwitzerlandFondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Centre of Preclinical Research, 20122 Milan, ItalyTumor recurrence after liver transplantation has been linked to multiple factors, including the recipient’s tumor burden, donor factors, and ischemia-reperfusion injury (IRI). The increasing number of livers accepted from extended criteria donors has forced the transplant community to push the development of dynamic perfusion strategies. The reason behind this progress is the urgent need to reduce the clinical consequences of IRI. Two concepts appear most beneficial and include either the avoidance of ischemia, e.g., the replacement of cold storage by machine perfusion, or secondly, an endischemic organ improvement through perfusion in the recipient center prior to implantation. While several concepts, including normothermic perfusion, were found to reduce recipient transaminase levels and early allograft dysfunction, hypothermic oxygenated perfusion also reduced IRI-associated post-transplant complications and costs. With the impact on mitochondrial injury and subsequent less IRI-inflammation, this endischemic perfusion was also found to reduce the recurrence of hepatocellular carcinoma after liver transplantation. Firstly, this article highlights the contributing factors to tumor recurrence, including the surgical and medical tissue trauma and underlying mechanisms of IRI-associated inflammation. Secondly, it focuses on the role of mitochondria and associated interventions to reduce cancer recurrence. Finally, the role of machine perfusion technology as a delivery tool and as an individual treatment is discussed together with the currently available clinical studies.https://www.mdpi.com/1422-0067/23/17/9747hepatocellular carcinomaliver transplantationmitochondriaischemia reperfusion injurycancer recurrencemachine perfusion |
| spellingShingle | Alessandro Parente Mauricio Flores Carvalho Janina Eden Philipp Dutkowski Andrea Schlegel Mitochondria and Cancer Recurrence after Liver Transplantation—What Is the Benefit of Machine Perfusion? International Journal of Molecular Sciences hepatocellular carcinoma liver transplantation mitochondria ischemia reperfusion injury cancer recurrence machine perfusion |
| title | Mitochondria and Cancer Recurrence after Liver Transplantation—What Is the Benefit of Machine Perfusion? |
| title_full | Mitochondria and Cancer Recurrence after Liver Transplantation—What Is the Benefit of Machine Perfusion? |
| title_fullStr | Mitochondria and Cancer Recurrence after Liver Transplantation—What Is the Benefit of Machine Perfusion? |
| title_full_unstemmed | Mitochondria and Cancer Recurrence after Liver Transplantation—What Is the Benefit of Machine Perfusion? |
| title_short | Mitochondria and Cancer Recurrence after Liver Transplantation—What Is the Benefit of Machine Perfusion? |
| title_sort | mitochondria and cancer recurrence after liver transplantation what is the benefit of machine perfusion |
| topic | hepatocellular carcinoma liver transplantation mitochondria ischemia reperfusion injury cancer recurrence machine perfusion |
| url | https://www.mdpi.com/1422-0067/23/17/9747 |
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