The First Case of Ischemia-free Organ Transplantation in Humans: A Proof of Concept.

Abstract

Ischemia and reperfusion injury (IRI) is an inevitable event in conventional organ transplant procedure and is associated with significant mortality and morbidity post-transplantation. We hypothesize that IRI is avoidable if the blood supply for the organ is not stopped, thus resulting in optimal transplant outcomes. Here we described the first case of a novel procedure called ischemia-free organ transplantation (IFOT) for patients with end-stage liver disease. The liver graft with severe macrovesicular steatosis was donated from a 25-year-old man. The recipient was a 51-year-old man with decompensated liver cirrhosis and hepatocellular carcinoma. The graft was procured, preserved and implanted under continuous normothermic machine perfusion. The recipient did not suffer post-reperfusion syndrome or vasoplegia after revascularization of the allograft. The liver function test and histological study revealed minimal hepatocyte, biliary epithelium and vascular endothelium injury during preservation and post-transplantation. The inflammatory cytokine levels were much lower in IFOT than those in conventional procedure. Key pathways involved in IRI were not activated after allograft revascularization. No rejection, vascular or biliary complications occurred. The patient was discharged on day 18 post-transplantation. This marks the first case of IFOT in humans, offering opportunities to optimize transplant outcomes and maximize donor organ utilization. This article is protected by copyright. All rights reserved.

DOI: 10.1111/ajt.14583

Cite this paper

@article{He2017TheFC, title={The First Case of Ischemia-free Organ Transplantation in Humans: A Proof of Concept.}, author={Xiao-shun He and Zhiyong Guo and Qiang Zhao and Weiqiang Ju and Dongping Wang and Linwei Wu and Lu Yang and Fei Ji and Yunhua Tang and Zhiheng Zhang and Shanzhou Huang and Linhe Wang and Zebin Zhu and Kunpeng Liu and Yanling Zhu and Yifang Gao and Wei Xiong and Ming Han and Bing Liao and Maogen Chen and Yi Ma and Xiaofeng Zhu and Wenqi Huang and Changjie Cai and Xiangdong Guan and Xian Chang Li and Jiefu Huang}, journal={American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons}, year={2017} }