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. 2019 Jul 28;33(4):221-234.
doi: 10.7555/JBR.32.20180087.

Hepatic ischemia-reperfusion injury in liver transplant setting: mechanisms and protective strategies

Sanketh Rampes  1 , Daqing Ma  2
Affiliations

Hepatic ischemia-reperfusion injury in liver transplant setting: mechanisms and protective strategies

Sanketh Rampes et al. J Biomed Res. .

Abstract

Hepatic ischemia-reperfusion injury is a major cause of liver transplant failure, and is of increasing significance due to increased use of expanded criteria livers for transplantation. This review summarizes the mechanisms and protective strategies for hepatic ischemia-reperfusion injury in the context of liver transplantation. Pharmacological therapies, the use of pre-and post-conditioning and machine perfusion are discussed as protective strategies. The use of machine perfusion offers significant potential in the reconditioning of liver grafts and the prevention of hepatic ischemia-reperfusion injury, and is an exciting and active area of research, which needs more study clinically.

Keywords: ischemic preconditioning; liver transplantation; mechanism; reperfusion injury; therapeutics.

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Figures

1
1
Schematic showing the timeline of the different phases of hepatic ischaemia-reperfusion injury (IRI).
A simplified schematic detailing the individual effects of ischemia and reperfusion and their interaction to cause damage to the liver. MPT: mitochondrial permeability transition; ROS: reactive oxygen species; NO: nitrous oxide; ET: endothelin; MODS: multiple organ dysfunction syndrome; SIRS: systemic inflammatory response syndrome.
2
Pathophysiology of hepatic ischemia-reperfusion injury (IRI).
A simplified schematic detailing the shared mechanisms involved in the action of IPC and IPostC. IPC and IPostC have been shown to have similar efficacy in most outcomes. IPC has been shown in several studies to be more effective than IPostC in attenuating IRI-induced apoptosis.
3
Mechanisms of action of ischaemic preconditioning (IPC) and ischaemic postconditioning (IPostC).
See this image and copyright information in PMC

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