Steatohepatitis and liver transplantation

Problem

Liver transplantation is the only treatment available for end-stage liver disease and some forms of liver tumors.

The success of liver transplantation hinges in the short term on having an adequate supply of good-quality livers to transplant and in the long(er) term on preventing allograft rejection while simultaneously minimizing the risk for chronic diseases due to the use of immunosupression.

Approach

This group focuses on optimizing the number of organs available for transplantation by improving techniques of procurement and preservation as well as improving the survival and quality of life of transplanted patients.

In order to achieve these aims, this group has lines of research in basic science/experimental research, translational/pre-clinical models, and clinical investigation. This is a multidisciplinary group comprised of surgeons, hepatologists, anesthesiologists, immunologists, and biologists, with the common goal of improving scientific understanding and above all the lives of the patients, we come into contact with each day.

Impact

Being an interdisciplinary research group gives us a key vision to continue advancing into liver transplantation process research.

In relation to ischemia and graft preservation, important contributions have been made in terms of the preservation solution used to maintain the grafts after its procurement and related to the development of advanced forms of in-situ and ex-situ liver perfusion, allowing recover and transplant safely suboptimal livers, such as the ones from donors that suffer cardiac arrest.

The group has also established which patients have operational tolerance, i.e., those who require no immunosuppression, and it has defined immunosuppression status markers to help personalize the administration of immunosuppressant drugs. Another area of research has aimed to identify the cardiovascular risk factors that significantly impact on the prognosis after liver transplantations, which makes it necessary to personalize immunosuppression.

Furthermore, in relation to hemostasis and coagulation, we have defined some independent risk factors for post-transplant venous thrombotic events that facilitate the management of these serious complications depending on the associated risk factors.

Biliary complications represent the most important source of morbidity after liver transplantation. The group has been focused on optimizing the diagnosis and management of these detrimental complications that importantly affect the quality of life of liver transplant patients. Thus, we have been able to refine our guidelines to determine the best optimal strategy for our patients.