Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Sep 18, 2024; 14(3): 92859
Published online Sep 18, 2024. doi: 10.5500/wjt.v14.i3.92859
Donor hepatectomy time and liver transplantation outcomes: An opportunity that cannot be dismissed
Francisca Gonzalez Cohens, Fernando M Gonzalez
Francisca Gonzalez Cohens, Web Intelligence Centre, Faculty of Physics and Mathematical Sciences, Universidad de Chile, Santiago 7500922, Chile
Fernando M Gonzalez, Department of Nephrology, Faculty of Medicine, Universidad de Chile, Santiago 7500922, Chile
Author contributions: Gonzalez Cohens F and Gonzalez FM wrote parts of the manuscript and revised the entire manuscript.
Conflict-of-interest statement: All authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fernando M Gonzalez, MD, Full Professor, Department of Nephrology, Faculty of Medicine, Universidad de Chile, Avenida Salvador 486, Providencia, Santiago 7500922, Chile. fgonzalf@uc.cl
Received: February 7, 2024
Revised: May 6, 2024
Accepted: May 23, 2024
Published online: September 18, 2024
Processing time: 174 Days and 8.3 Hours
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.