Oncologic Outcomes of Interventions to Decrease Allograft Ischemia-Reperfusion Injury within Patients Undergoing Liver Transplantation for Hepatocellular Carcinoma: A Systematic Review

Author:

Faleiro Matheus D.1ORCID,Mir Zuhaib M.2ORCID,Azizieh Yara3ORCID,Hiebert Stephanie E.2,Livingstone Scott M.2,Walsh Mark J.2,Gala-Lopez Boris L.234ORCID

Affiliation:

1. Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil

2. Department of Surgery, Dalhousie University, Halifax, NS B3H 4R2, Canada

3. Department of Pathology, Dalhousie University, Halifax, NS B3H 4R2, Canada

4. Beatrice Hunter Cancer Research Institute, Halifax, NS B3H 0A2, Canada

Abstract

Ischemia-reperfusion injury (IRI) during liver transplantation has been implicated in the recurrence of hepatocellular carcinoma (HCC). This systematic review aimed to evaluate interventions to reduce IRI during liver transplantation for HCC and their impact on oncologic outcomes. A comprehensive literature search retrieved four retrospective studies involving 938 HCC patients, utilising interventions such as post-operative prostaglandin administration, hypothermic machine perfusion, and normothermic machine perfusion. Overall, treated patients exhibited reduced post-operative hepatocellular injury and inflammation and significantly enhanced recurrence-free survival. Despite these promising results, the impact of these interventions on overall survival remains unclear. This underscores the imperative for further prospective research to comprehensively understand the efficacy of these interventions in HCC patients undergoing transplantation. The findings highlight the potential benefits of these strategies while emphasising the need for continued investigation into their overall impact.

Funder

Global Affairs Canada Scholarship

Dalhousie University Faculty of Medicine Graduate Studentship

Department of Surgery at Dalhousie University

Publisher

MDPI AG

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