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Severe (\u226560%) hepatic macrosteatosis was induced by a high\u2010fat diet (HFD) for 6\u00a0weeks, after which the rats were randomly divided into four following groups: Control group, with lean livers being preserved in static cold storage (SCS) at 0\u00b0C\u20104\u00b0C for 45\u00a0minutes; SCS group, with a steatotic liver graft (SLG) being preserved in SCS at 0\u00b0C\u20104\u00b0C for 4\u00a0hours; HOPE group, where SLG was perfused with 3\u2010hours HOPE followed by 1\u2010hours SCS; and HOPE\u00a0+\u00a0DF group, HOPE with the addition of DF. Graft function after orthotopic liver transplantation was assessed in terms of mitochondrial function (adenosine triphosphate [ATP], Glycogen), endoplasmic reticulum stress (PPY, GRP78, CHOP, and ATF\u20106), cell apoptosis (Tunel assay, Caspase\u20103), inflammatory level (HMGB1, TLR4, IL\u20101\u03b2, IL\u20106. TNF\u2010\u03b1, Factor V), and posttransplantation survival. HOPE protected steatotic liver grafts from microcirculation disturbance and endoplasmic reticulum stress and then promoted ATP and glycogen synthesis that improved mitochondrial function. Meanwhile, under conditions of ischemia\u2010reperfusion injury, it prevented nuclear injury and endothelial damage by suppressing the release of an inflammatory mediator. The high efficacy of HOPE was enhanced after the addition of the DF. DF agents cannot promote the lipid decomposition of the steatotic liver graft at 0\u00b0C\u20104\u00b0C, but they can further improve steatotic liver and postoperative survival compared to the HOPE. The defatted steatotic liver grafts can be safely used in rat orthotopic liver transplantation.<\/jats:p>","DOI":"10.1111\/aor.13976","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T08:55:38Z","timestamp":1619600138000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Hypothermic oxygenated perfusion with defatting cocktail further improves steatotic liver grafts in a transplantation rat model"],"prefix":"10.1111","volume":"45","author":[{"given":"Fan","family":"Lin","sequence":"first","affiliation":[{"name":"Hubei Key Laboratory of Medical Technology on Transplantation Transplant Center of Wuhan University Institute of Hepatobiliary Diseases of Wuhan University Zhongnan Hospital of Wuhan University Wuhan PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fu","family":"Zhen","sequence":"additional","affiliation":[{"name":"Hubei Key Laboratory of Medical 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