Rev Col Bras Cir. 2026 Aug 3;53:e2026002925. doi: 10.1590/0100-6991e-2026002925-en. eCollection 2026.
ABSTRACT
INTRODUCTION: Ischemia-reperfusion injury (IRI) is a major determinant of initial graft function after liver transplantation (LT), directly influencing the incidence of early dysfunction and short-term clinical outcomes. Macrophage migration inhibitory factor (MIF), a pleiotropic cytokine involved in inflammatory pathways and mechanisms of cellular adaptation to oxidative stress, may play a modulatory role in IRI, although its immediate tissue behaviour in grafts remains poorly characterised.
METHODS: We retrospectively evaluated adult LT recipients who underwent post-reperfusion biopsies suitable for histological and immunohistochemical analysis. Immunohistochemical expression of MIF was quantified using the IHC Profiler plugin (ImageJ), whereas IRI was graded according to validated histopathological criteria.
RESULTS: Among 153 biopsies analysed, 103 met the eligibility criteria, with most cases showing absent or mild IRI (70.9%). Hepatocellular expression of MIF was predominantly weak or moderate. Stronger immunohistochemical staining for MIF was associated with lower IRI severity (p<0.05). MIF expression correlated with pre-transplant laboratory parameters, without association with steatosis or early outcomes, including retransplantation or death within 15 days.
CONCLUSION: The findings suggest that greater immunohistochemical expression of MIF at reperfusion is associated with lower IRI intensity, indicating a possible adaptive role for this cytokine during this critical phase. MIF emerges as a potential tissue marker complementary to traditional histopathological scoring, with relevance for graft assessment and use in contemporary liver perfusion strategies.
PMID:42561335 | DOI:10.1590/0100-6991e-2026002925-en