Líneas de investigación

• 1. Ischemia-reperfusion injury and expanding criteria for liver graft acceptance

  Maintaining the viability of organs from their recovery to transplantation is a key factor for transplant success and graft survival. Organ damage occurs primarily as a result of ischemia-reperfusion injury, in particular when grafts are of more marginal quality (e.g., older, steatotic, and/or arising from donation after circulatory death donors). Consequently, the group focuses on:

  • comparing the viability of livers using different preservation solutions in preclinical models
  • characterizing and investigating the use of different perfusion solutions and components during normothermic regional perfusion in donation after circulatory death donors
  • evaluating extended ex situ preservation of livers on a novel normothermic machine perfusion device
  • evaluating the capacity of normothermic perfusion systems to facilitate liver regeneration

• 2. Endoscopic management of biliary complications following liver transplantation

  The study of biliary complications after liver transplantation has high clinical relevance, due it relatively high incidence, complexity of management, and impact on outcomes. Consequently, the group focuses on:

  • assessing the prevalence and risk factors of sphincter of Oddi dysfunction in liver transplant patients
  • assessing the role of endoscopic retrograde cholangiography in comparison with magnetic resonance imaging for the diagnosis of bile duct complications in liver transplant patients
  • evaluating the use of digital cholangioscopy to describe and classify biliary strictures after liver transplantation and thus personalize treatment
  • assessing whether the presence of pro-healing factors predicts the response to the treatment of biliary strictures after liver transplantation

• 3. Expanding indications for liver transplantation in relation to pre-existing portal vein thrombosis and portal hypertension

  It is widely known that portal vein thrombosis is a serious complication of chronic liver disease, and the prognosis of liver transplantation depends, in part, on its. Consequently, the group focuses on:

  • evaluating the impact of the portal pressure gradient on the transfusion of blood products in liver transplantation through a multicenter study with other Spanish hospitals
  • evaluating blood product consumption in liver transplantation in anticoagulated patients
  • developing a computational mechanistic model based on peripheral blood parameters to predict the appearance of portal vein thrombosis in cirrhotic patients
  • evaluating non-anatomical and non-physiological strategies for liver allograft revascularization in cases with extensive portal vein thrombosis through a multicenter international registry

• 4. Expanding indications for transplantation for malignant tumors – hilar cholangiocarcinoma and colorectal cancer liver metastases

  The decrease in the number of patients on liver transplant waiting lists due to the advent of effective treatment for hepatitis C virus has generated great interest in expanding transplant indications for liver cancer pathology. In this regard, this group is actively participating in clinical trials to transplant patients with unresectable hilar cholangiocarcinoma and colorectal cancer liver metastases.

• 5. Alloimmune response, complications associated with immunosupression, and operational tolerance

  Treatment with immunosupression is associated with a series of risks for the transplanted patient, making minimization key to optimizing post-transplant survival and quality-of-life. Consequently, the group focuses on:

  • early identification of cellular rejection and antibody-mediated rejection, in to characterize it histologically and genetically and thus improve its prognosis
  • alloimmune response characterization in patients who develop de novo neoplasms following liver transplantation, in order optimize immunosupression management
  • identification and validation of non-invasive biomarkers predictive of rejection and clinical evolution of the liver graft

• 6. Prevention and treatment of cardiovascular risk factors following liver transplantation

  Cardiovascular diseases represent one of the most common causes of long-term morbidity and mortality after liver transplantation. This group focuses on strategies to prevent and treat cardiovascular disease and its complications, in order to improve the quality of life and survival of liver transplant recipients.