RESUMO
Organ preservation fluid could mitigate cold ischemia injury and maintain normal function of the grafts. At present, how to reduce a series of injury caused by cold ischemia of donor liver and improve the preservation quality of grafts are the hot and challenging spots in this field. Currently, preservation fluid in clinical practice has not achieved ideal preservation effect, especially for the protection of marginal donor organs. In the context of severe donor shortage, the key solution is still to explore the optimal preservation protocol for donor liver to prevent grafts from cold ischemia injury. In this article, the mechanism of donor liver injury during cold ischemia, the classification and evolution of donor liver preservation fluid were summarized, the development direction and challenges of donor liver preservation fluid were discussed, aiming to provide novel ideas and references for the research and development of donor liver preservation fluid.
RESUMO
In recent years, organ transplantation has developed rapidly in China, whereas the proportion of supply and demand of organs for donation is severely unbalanced. To resolve the shortage of donor livers, repairing extended criteria donor liver and improving the quality of donor liver are critical research directions. Mesenchymal stem cell (MSC) is a category of stem cells with self-renewal and differentiation potential, which possess the functions of immunomodulation and tissue repair. The derivatives of MSC have the advantages of low immunogenicity and high biocompatibility, which have been widely applied in the treatment of multiple diseases. In this article, research progress on the role of MSC, exosomes and extracellular vesicles in alleviating liver steatosis, repairing ischemia-reperfusion injury and promoting the regeneration of small-for-size liver allograft was reviewed, and the feasibility and safety of MSC and the derivatives in repairing donor liver were summarized, aiming provide novel ideas for repairing marginal donor liver and enhancing the quality of liver allograft.
RESUMO
Radical hepatectomy and liver transplantation are the best choices to improve the long-term prognosis of patients with primary liver cancer; however, most of the patients in China have lost the opportunity for surgical treatment at the time of confirmed diagnosis. Therefore, conversion therapy has become a research hotspot in improving the survival rate of patients with advanced liver cancer. This article briefly describes the evaluation of conversion therapy for liver cancer and summarizes the current conversion treatment regimens for unresectable liver cancer. With the deepening of the understanding of primary liver cancer and individualized treatment, the group of precise treatment combined with multidisciplinary diagnosis and treatment develops the regimens for individualized conversion therapy, which is considered to effectively improve the surgical resection rate, treatment outcome, and long-term prognosis of patients with advanced liver cancer.
RESUMO
Mesenchymal stem cells (MSC) are derived from the mesoderm, and exhibit multipotential differentiation. MSC can alleviate liver fibrosis and improve liver function through paracrine cytokines and cell-cell interactions, but their therapeutic mechanism remains unknown. MSC are derived from various tissues, such as bone marrow, umbilical cord tissue, umbilical cord blood, peripheral blood, and adipose tissue. However, there are different advances in MSC with various sources in experimental studies and clinical treatment of liver fibrosis. This paper summarizes the possible therapeutic mechanisms of MSC in alleviating liver fibrosis, as well as the advances in experimental studies and clinical application of MSC with various sources. MSC transplantation is a new therapeutic method for liver fibrosis and has a broad application prospect in this field.