Cesaretti M, Izzo A, Pellegrino RA, Galli A, Mavrothalassitis O. Cold ischemia time in liver transplantation: An overview. World J Hepatol 2024; 16(6): 883-890 [PMID: 38948435 DOI: 10.4254/wjh.v16.i6.883]
Corresponding Author of This Article
Manuela Cesaretti, MD, PhD, Assistant Professor, Surgeon, Department of HPB and Liver Transplantation, Brotzu Hospital, 100 Boulevard du Général Leclerc, Cagliari 09122, Italy. manuela.csr02@gmail.com
Research Domain of This Article
Transplantation
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Jun 27, 2024; 16(6): 883-890 Published online Jun 27, 2024. doi: 10.4254/wjh.v16.i6.883
Cold ischemia time in liver transplantation: An overview
Manuela Cesaretti, Alessandro Izzo, Roberta Anna Pellegrino, Alessandro Galli, Orestes Mavrothalassitis
Manuela Cesaretti, Alessandro Izzo, Roberta Anna Pellegrino, Department of HPB and Liver Transplantation, Brotzu Hospital, Cagliari 09122, Italy
Manuela Cesaretti, Department of Nanophysic, Istituto Italiano di Tecnologia, Genova 16163, Italy
Alessandro Galli, Department of Critical Care Medicine and Anesthesia, ASST Papa Giovanni XXIII, Bergamo 24100, Italy
Alessandro Galli, Orestes Mavrothalassitis, Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA 94143, United States
Co-corresponding authors: Manuela Cesaretti and Orestes Mavrothalassitis.
Author contributions: Cesaretti M, Izzo A, Galli A, and Pellegrino RA drafted the article, revised it critically for important intellectual content; Cesaretti M and Mavrothalassitis O contributed to conception and design, acquisition, analysis and interpretation of data; Cesaretti M and Mavrothalassitis O gave the final approval of the version to be published, they are co-corresponding authors of this manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Manuela Cesaretti, MD, PhD, Assistant Professor, Surgeon, Department of HPB and Liver Transplantation, Brotzu Hospital, 100 Boulevard du Général Leclerc, Cagliari 09122, Italy. manuela.csr02@gmail.com
Received: March 4, 2024 Revised: April 26, 2024 Accepted: May 20, 2024 Published online: June 27, 2024 Processing time: 107 Days and 13.7 Hours
Abstract
The standard approach to organ preservation in liver transplantation is by static cold storage and the time between the cross-clamping of a graft in a donor and its reperfusion in the recipient is defined as cold ischemia time (CIT). This simple definition reveals a multifactorial time frame that depends on donor hepatectomy time, transit time, and recipient surgery time, and is one of the most important donor-related risk factors which may influence the graft and recipient’s survival. Recently, the growing demand for the use of marginal liver grafts has prompted scientific exploration to analyze ischemia time factors and develop different organ preservation strategies. This review details the CIT definition and analyzes its different factors. It also explores the most recent strategies developed to implement each timestamp of CIT and to protect the graft from ischemic injury.
Core Tip: Many variables affect liver transplantation outcomes. Among these variables, cold ischemia time (CIT), defined as the time from the cold flushing of the donor organ until the graft is removed from ice to be implanted into the recipient, is the one of the most important and is incorporated into many predictive scoring systems. CIT is a multifactorial variable that depends on donor hepatectomy time, transit time and recipient surgery time and can only be calculated retrospectively.
