Donor hepatectomy time and liver transplantation outcomes: An opportunity that cannot be dismissed

Abstract

The probability of developing primary dysfunction (PD) is a function of the probability of ischemia/reperfusion (I/R) injury. The probability of I/R injury in turn, is a function of several donor and transplantation process variables, among which is ischemia time. Custodio et al studied the duration of a special type of warm ischemia and showed, contrary to what is known, that a longer duration is not statistically different from a shorter one in PD development. This finding opens the door to the unforeseen opportunity of training fellows in performing hepatectomies, since the duration will not jeopardize liver transplant outcomes, albeit with some precautions.

Keywords: Cold ischemia; Warm ischemia; Liver transplantation; Reperfusion; Primary dysfunction

Core Tip: Custodio et al studied the duration of a novel warm ischemia, finding no differences in liver primary dysfunction among long and short times. Longer ischemia time is known to increase primary dysfunction probability, so this contradictory finding opens the door for an unforeseen opportunity that can improve liver transplantation outcomes.