Liver ischemia and reperfusion injury. Pathophysiology and new horizons in preconditioning and therapy

• Autor(a) principal: Nakazato,Paula Carolina Grande
• Data de Publicação: 2018
• Outros Autores: Victorino,João Paulo, Fina,Clarice Fleury, Mendes,Karina Dal Sasso, Gomes,Maria Cecília Jordani, Evora,Paulo Roberto Barbosa, D’Albuquerque,Luiz Augusto Carneiro, Castro-e-Silva,Orlando
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Acta Cirúrgica Brasileira (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-86502018000800723
• topic: Liver; Ischemia; Reperfusion Injury

Abstract It is well known that during hepatic operative procedures, it is often critical that the irrigation is interrupted to avoid possible bleeding, blood transfusions, variable intensities, and their short and long-term consequences. It was believed in the past that the flow interruption should not exceed 20 minutes, which limited the use of this maneuver. However, it has been postulated that ischemia could be maintained for more than 60 minutes in healthy livers. The present paper review includes: 1) A brief introduction to justify the rationale of the review design; 2) Aspects of the pathophysiology of the three stages of the liver ischemia-reperfusion injury; 3) The innate and acquired immunity; 4) Oxidative stress; 5) Apoptosis and autophagy, Some essential biomarkers (Tumor Necrosis Factor-α, nitric oxide, metalloproteinases); and, finally; 6) Preventive (“cheating”) strategies, non-pharmacological and pharmacological options to treat the liver IR injury.