Abstract
BACKGROUND: Shortening the recipient warm ischemia time (rWIT) has been proven to be effective for improving the short- and long-term outcomes after liver transplantation (LT) and offsets the negative impact of an extended cold ischemia time. However, few studies have been conducted to explore the prognostic effects of shortening the rWIT in transplantations using a liver graft from an extended-criteria donor (ECD). AIM: To investigate whether shortening the rWIT could improve the outcomes of ECD LT. METHODS: Rat ECD autologous orthotopic LT were performed with variable rWITs (0, 10, 20, and 30 minutes). Near-infrared fluorescence imaging (FI) was used for the real-time assessment of liver graft ischemia-reperfusion injury after the anhepatic phase. Survival was assessed, and liver function and histological analyses were performed on the third day after transplantation. RESULTS: The FI curve growth rate and postoperative three-day survival rate significantly increased, and the liver function and Suzuki score of the liver grafts significantly improved when the rWIT was ≤ 10 minutes (P < 0.05). CONCLUSION: The post-transplant outcomes were significantly better with a shorter rWIT (10 minutes or less) than with a longer rWIT, which could be a strategy for expanding the liver donor pool.