Abstract
The incidence rate of liver cancer is increasing year by year globally. Liver transplantation has become one of the therapeutic methods for patients with liver cancer. In the past, ischemia-reperfusion injury (IRI) was unavoidable in liver transplantation, compromising recipient and graft survival. At the same time, the imbalance between the supply and demand of organs limits the use of transplantation in patients with liver cancer. Recently, advances have been made in machine perfusion techniques to reduce graft IRI. However, none of the techniques can completely abrogate graft IRI. In 2017, the concept of ischemia-free organ transplantation (IFOT) was proposed, and our group conducted the first case of ischemia-free liver transplantation (IFLT). We then extended the concept of IFOT to kidney transplantation in 2018 and to heart transplantation in 2021. Here, we review the history, strengths, and weaknesses, and the future direction of IFOT, particularly in patients with liver cancers.
Highlights
OPEN ACCESSReceived 30 September 2021, Accepted 13 October 2021, Published online 1 December 2021
In the past 60 years, cancer has become the first or second leading cause of premature death in 134 of 183 countries and the third or fourth primary cause in the rest of the countries according to the WHO’s Global Health Estimates [1]
The preliminary data suggest that ischemia-free liver transplantation (IFLT) can reduce cancer recurrence
Summary
Received 30 September 2021, Accepted 13 October 2021, Published online 1 December 2021. Liver transplantation has become one of the therapeutic methods for patients with liver cancer. Ischemia-reperfusion injury (IRI) was unavoidable in liver transplantation, compromising recipient and graft survival. The imbalance between the supply and demand of organs limits the use of transplantation in patients with liver cancer. Advances have been made in machine perfusion techniques to reduce graft IRI. None of the techniques can completely abrogate graft IRI. In 2017, the concept of ischemia-free organ transplantation (IFOT) was proposed, and our group conducted the first case of ischemia-free liver transplantation (IFLT). We extended the concept of IFOT to kidney transplantation in 2018 and to heart transplantation in 2021. We review the history, strengths, and weaknesses, and the future direction of IFOT, in patients with liver cancers
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