Thermal homeostasis and liver transplantation.
Thermal homeostasis represents the major issue during liver transplantation (OLT) since severe hypothermia may have a deleterious effect on both liver recipient organism and postoperative graft functioning. Because of the known negative influence of hypothermia on intraoperative cardiovascular activity and coagulation system, numerous methods have been suggested to reduce intraoperative heat loss and promote active warming (continuous temperature monitoring, external heat sources, improvement in surgical technique and technologies). A good intraoperative OLT course has an obvious influence on post OLT graft function recovery, but thermal homeostasis has also an essential direct effect on the graft as a constitutive component of conventional cold preservation methods. Hypothermia, however, contributes directly to the graft ischemia-reperfusion injury particularly in marginal and partial organs by several angiogenic mechanisms. For these reasons, on the light of the development of new strategies to increase the donor pool, clinical research is focusing on new preservation methods such as extracorporeal circuits with normothermic oxygenated perfusion.
D'Amico
Davide Francesco
DF
Department of Surgical and Gastroenterological Sciences, University of Padua, School of Medicine, Padova, Italy.
Vitale
Alessandro
A
Cillo
Umberto
U
Boccagni
Patrizia
P
Brolese
Alberto
A
Zanus
Giacomo
G
Bassanello
Marco
M
Montin
Umberto
U
Gringeri
Enrico
E
D'Amico
Francesco
F
Ciarleglio
Francesco
F
Cappuzzo
Gianluca
G
Carraro
Amedeo
A
D001833:Body Temperature Regulation; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects*; D016031:Liver Transplantation