Ischemia-free liver transplantation improves long-term outcomes in a 5-year follow-up study

作者：Zehua Jia, Jiaxing Zhu, Jiayi Zhang, Jiän Zhang, Changjun Huang, Niancun Zhang, S. Li, Yuqi Dong, Yao Liu, Ping Zeng, Tielong Wang, Zhitao Chen, Yunhua Tang, Qiang Zhao, Maogen Chen, Yinghua Chen, Anbin Hu, Weiqiang Ju, Yi Ma, Dongping Wang, Xiao‐Feng Zhu, Andrea Schlegel, Tullius G. Stefan, Xiao‐Shun He, Zhiyong Guo · 发表于：JHEP Reports · 年份：2025 · DOI：10.1016/j.jhepr.2025.101393 · 被引用次数：7 · 研究领域：Organ Transplantation Techniques and Outcomes、Hepatocellular Carcinoma Treatment and Prognosis、Liver Disease and Transplantation

Ischemia-free liver transplantation (IFLT) is a novel technique designed to avoid ischemia-reperfusion injury (IRI). Here, we report the first detailed 5-year follow-up outcomes. We conducted a cohort study comparing long-term outcomes between IFLT and conventional liver transplantation (CLT) recipients of livers donated after brain death (DBD). The primary objective was to evaluate 5-year patient and graft survival. Additional endpoints included graft loss, biliary complications, rejection, infections and liver-related laboratory tests. Subgroup analysis was performed to validate the generalizability of the results in patients with pre-transplant hepatocellular carcinoma (HCC). A total of 168 patients were enrolled, with 38 patients in the IFLT group and 130 patients in the CLT group. 5-year patient survival (86.84% vs. 56.92%, HR=0.246, 95% CI: 0.098-0.620; p < 0.01) and graft survival (84.61% vs. 56.92%, HR=0.307, 95% CI: 0.131-0.719; p < 0.01) rates were significantly improved in the IFLT group compared with the CLT group. In the multivariate analysis, IFLT emerged as an independent protective factor for 5-year patient survival (HR=0.246, 95% CI: 0.098-0.620; p < 0.01). Conversely, HCC prior to transplantation (HR=2.039, 95% CI: 1.159-3.590; p < 0.05), donor age (HR=1.022, 95% CI: 1.001-1.040; p < 0.05), and extended criteria donor (HR=2.088, 95% CI: 1.215-3.590; p < 0.01) were identified as independent risk factors for impaired 5-year patient survival. In patients with p...