Innovative Magnetic Anastomosis Enables Immediate Liver Transplantation Without Cold Preservation

Abstract Background Living donor liver transplantation (LDLT) traditionally relies on static cold preservation, which can trigger significant ischemia-reperfusion injury due to abrupt temperature shifts. This study investigated the feasibility of immediate liver transplantation without cold storage using rapid magnetic anastomosis techniques. Methods Eighty-eight adult male Sprague-Dawley rats were randomly divided into two groups: Cold Storage Transplantation Group (CSTG) and Immediate Transplantation Group (ITG). Partial liver transplantation was performed using magnetic anastomosis, with the ITG group undergoing direct transplantation without cold preservation. Thermal imaging, histological analysis, oxidative stress markers, cellular proliferation, apoptosis, liver function tests, and inflammatory responses were evaluated at 1- and 5-days post-transplantation. Results The ITG demonstrated several key advantages: more stable temperature profiles during transplantation, significantly reduced oxidative stress during the ex vivo phase, enhanced hepatocyte proliferation and decreased cellular apoptosis ( P < 0.05 at day 5). Liver function markers showed improved recovery in the ITG, with significantly lower alanine aminotransferase (ALT) and higher albumin (ALB) levels on day 5 ( P < 0.05 at day 5). The 14-day survival rates were comparable between groups (80% ITG vs. 70% CSTG, P = 0.629). Conclusions Immediate liver transplantation using magnetic anastomosis appears feasible and potentially beneficial, offering a novel approach that mitigates ischemia-reperfusion injury by avoiding cold storage. This method demonstrates promising outcomes in terms of graft viability, cellular regeneration, and functional recovery. Further research in large animal models is warranted to validate these findings for potential clinical application.