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The cold temperatures associated with flushing and storage during organ preservation result in blockage of the Na + -K + ATPase pump and the K + leak channel

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36 Conditions favoring either aerobic or anaerobic bacteria lead to shifts in microbial species dominance, with facultative anaerobes thriving in varied oxygen conditions and obligate anaerobes preferring reduced redox states

These mutations occur in genes that regulate cell cycle, DNA repair, and angiogenesis and favor cell growth and survival, resulting in abnormal cell growth and division, unlimited proliferation and spreading of cells (by overriding the normal cell cycle regulation and evading programmed cell death), and tumor formation (Long et al., 2019

Excess acetaldehyde increases homocysteine (Hcy) conversion to methionine but reduces glutathione (GSH), allowing ROS to damage liver cells and raise GGT levels