Yu Jia-Wei, Xiang Lin-Biao, Dong Xiao-Juan, Yang Chen-Xi, Wang Lei, Liu Xiao-Yu, Song Yi-Hong, Bai Xian-Jie, Xiao Jing-Wen, Ren Lu, Xu Qin-Hong, Yang Gang-Hua, Lv Yi, Lu Qiang
National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
World J Gastroenterol. 2025 Mar 7;31(9):103188. doi: 10.3748/wjg.v31.i9.103188.
Shortening the recipient warm ischemia time (rWIT) has been proven to be effective for improving the short- and long-term outcomes after liver transplantation (LT) and offsets the negative impact of an extended cold ischemia time. However, few studies have been conducted to explore the prognostic effects of shortening the rWIT in transplantations using a liver graft from an extended-criteria donor (ECD).
To investigate whether shortening the rWIT could improve the outcomes of ECD LT.
Rat ECD autologous orthotopic LT were performed with variable rWITs (0, 10, 20, and 30 minutes). Near-infrared fluorescence imaging (FI) was used for the real-time assessment of liver graft ischemia-reperfusion injury after the anhepatic phase. Survival was assessed, and liver function and histological analyses were performed on the third day after transplantation.
The FI curve growth rate and postoperative three-day survival rate significantly increased, and the liver function and Suzuki score of the liver grafts significantly improved when the rWIT was ≤ 10 minutes ( < 0.05).
The post-transplant outcomes were significantly better with a shorter rWIT (10 minutes or less) than with a longer rWIT, which could be a strategy for expanding the liver donor pool.
缩短受体热缺血时间（rWIT）已被证明对改善肝移植（LT）后的短期和长期预后有效，并可抵消延长冷缺血时间的负面影响。然而，很少有研究探讨在使用边缘供体（ECD）肝脏移植物的移植中缩短rWIT的预后效果。
研究缩短rWIT是否能改善ECD LT的预后。
对大鼠进行ECD自体原位肝移植，设置不同的rWIT（0、10、20和30分钟）。在无肝期后，使用近红外荧光成像（FI）实时评估肝移植物的缺血再灌注损伤。评估生存率，并在移植后第三天进行肝功能和组织学分析。
当rWIT≤10分钟时，FI曲线增长率和术后三天生存率显著提高，肝移植物的肝功能和铃木评分显著改善（<0.05）。
较短的rWIT（10分钟或更短）移植后预后明显优于较长的rWIT，这可能是扩大肝脏供体库的一种策略。
