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Review
. 2021 Feb 13;22(4):1864.
doi: 10.3390/ijms22041864.

Hemorheological and Microcirculatory Factors in Liver Ischemia-Reperfusion Injury-An Update on Pathophysiology, Molecular Mechanisms and Protective Strategies

Norbert Nemeth  1 , Katalin Peto  1 , Zsuzsanna Magyar  1 , Zoltan Klarik  1 , Gabor Varga  1 , Mihai Oltean  2 , Anna Mantas  3 , Zoltan Czigany  3 , Rene H Tolba  4
Affiliations
Review

Hemorheological and Microcirculatory Factors in Liver Ischemia-Reperfusion Injury-An Update on Pathophysiology, Molecular Mechanisms and Protective Strategies

Norbert Nemeth et al. Int J Mol Sci. .

Abstract

Hepatic ischemia-reperfusion injury (IRI) is a multifactorial phenomenon which has been associated with adverse clinical outcomes. IRI related tissue damage is characterized by various chronological events depending on the experimental model or clinical setting. Despite the fact that IRI research has been in the spotlight of scientific interest for over three decades with a significant and continuous increase in publication activity over the years and the large number of pharmacological and surgical therapeutic attempts introduced, not many of these strategies have made their way into everyday clinical practice. Furthermore, the pathomechanism of hepatic IRI has not been fully elucidated yet. In the complex process of the IRI, flow properties of blood are not neglectable. Hemorheological factors play an important role in determining tissue perfusion and orchestrating mechanical shear stress-dependent endothelial functions. Antioxidant and anti-inflammatory agents, ischemic conditioning protocols, dynamic organ preservation techniques may improve rheological properties of the post-reperfusion hepatic blood flow and target endothelial cells, exerting a potent protection against hepatic IRI. In this review paper we give a comprehensive overview of microcirculatory, rheological and molecular-pathophysiological aspects of hepatic circulation in the context of IRI and hepatoprotective approaches.

Keywords: hemorheology; hepatic ischemia-reperfusion; microcirculation; preventive and therapeutic strategies.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Various phases of ischemia reperfusion injury and their effects and mechanisms in the setting of deceased donor liver transplantation. Potential stages and interventional strategies to mitigate IRI during organ transplantation logistics. The figure was created with BioRender (https://biorender.com).
Figure 2
Figure 2
Major milestones in the history of hemorheology, ischemia-reperfusion and liver transplantation research. Publication activity in the field of rheological and ischemia-reperfusion injury research in liver disease and liver transplantation. Number of corresponding search hits in liver disease and liver transplantation in the PubMed® database. Accessed on 13th December 2020; search syntax: ((ischemia-reperfusion) OR (rheology)) AND (liver transplantation) // ((ischemia-reperfusion) OR (rheology)) AND (liver disease).
Figure 3
Figure 3
Schematic drawing of the liver microcirculation. The figure was created with BioRender (https://biorender.com).
See this image and copyright information in PMC

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