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BACKGROUND:?Liver? transplantation? is? the? therapy? of?choice?for?patients?with?end-stage?liver?diseases.?However,?the?gap?between?the?low?availability?of?organs?and?high?demand?is? continuously? increasing.? Innovative? strategies? for? organ?protection?are?necessary?to?expand?donor?pool?and?to?achieve?better?outcomes?for?liver?transplantation.?The?present?review?analyzed?and?compared?various?strategies?of?liver?protection.
DATA?SOURCES:?Databases?such?as?PubMed,?Embase?and?Ovid?were?searched?for?the?literature?related?to?donor?liver?protection?strategies? using? following? key? words:? "ischemia? reperfusion?injury",?"graft?preservation",?"liver?transplantation",?"machine?perfusion"? and? "conditioning".? Of? the? 146? studies? identified,?only?those?with?cutting?edge?strategies?were?analyzed.
RESULTS:?A?variety?of?therapeutic?approaches?were?proposed?to?alleviate?graft?ischemia/reperfusion?injury,?which?included?static?cold?storage,?machine?perfusion?(hypothermic,?normo-thermic? and? subnormothermic),? manual? conditioning? (pre,?post? and? remote),? and? pharmacological? conditioning.? Evi-dences?from?animal?experiments?and?clinical?trials?suggested?that? all? these? strategies? could? potentially? protect? liver? graft;?however,?their?clinical?applications?are?limited?partially?due?to?their?own?disadvantages.
CONCLUSIONS:?There? are? a? plenty? of? methods? suggested?to?decrease?the?degree?of?donor?liver?transplantation-related?injury.?However,?none?of?these?approaches?is?perfect?in?clinical?practice.? More? translational? researches? (molecular? and? clini-cal?studies)?are?needed?to?improve?the?techniques?in?liver?graft?protection.
