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Basic science
A novel method of liver preservation may alleviate the shortage of donor organs
▸ Berendsen TA, Bruinsma BG, Puts CF, et al. Supercooling enables long-term transplantation survival following 4 days of liver preservation. Nat Med 2014;20:790–3.
There is a shortage of donor organs for transplantation worldwide. One strategy to increase availability is to enhance organ preservation and allow more potentially available organs to be used successfully. Currently, viable preservation is available up to 12 h. Although various methods of supercooling to enhance preservation have been assessed, there are many challenges in applying this to whole organs and thus far this approach has been relatively unsuccessful in animal models. This current paper reports a novel 4-step method to extend preservation of fresh rat liver to beyond 72 h and still achieve successful transplantation outcome. The method employs supercooling, the use of 2 cryoprotectants (polyethylene glycol for extracellular cell membrane protection and a non-metabolised glucose derivative for intracellular protection) and subnormothermic machine preservation (SNMP) to overcome ischaemic–reperfusion injuries. Fresh rat liver preserved in this way for 72 and 96 h resulted in 100% and 58% post-transplant survival at 3 months, respectively. The authors were able to assess recovery parameters extensively throughout the SNMP phase and identified that the parameter of hepatic resistance at 30 min predicted organ viability and subsequent survival. This method is under further optimisation; validation in a larger experimental cohort is required and there may be challenges with inter-species translation. However, the undeniable proof-of-concept success of this method offers an exciting future advancement in transplant medicine.
The role of autophagy in liver regeneration
▸ Toshima T, Shirabe K, Fukuhara T, et al. Suppression of autophagy during liver regeneration impairs energy charge and hepatocyte senescence in mice. Hepatology 2014;60:290–300.
The liver has the unique ability to regenerate itself through a complex multistep process. Specifically, hepatocytes must awaken from senescence, enter cell cycle, replicate and finally return to a senescent state. Though this process is well known, the underlying …
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Provenance and peer review Not commissioned; internally peer reviewed.