Mechanism and advantages of hypothermic oxygenated machine perfusion in extended criteria donation liver transplantation
In recent years,due to the increasingly prominent shortage of liver transplant donors,more and more institutions have begun to use extended criteria donation(ECD)livers for transplantation.Howev-er,the incidence of postoperative complications and poor prognosis are higher for ECD liver transplantation.Hypothermic oxygenated machine perfusion(HOPE)is considered a method of preserving liver transplant do-nors that can improve the transplantation outcomes,especially for ECD livers.The main mechanisms of HOPE include reducing mitochondrial damage,oxidative stress damage,inflammation,and downregulating immune responses.Compared with other perfusion methods,HOPE can protect the function of the transplant,prolong the preservation time of the liver,and reduce postoperative complications.However,although HOPE has many advantages in clinical practice,its application is still in the exploratory stage,and its widespread use is limited by its high economic cost.Further research is needed in the future to fully demonstrate and realize the clinical role of HOPE,so that it can be better applied in clinical practice.
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