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Ischemia-reperfusion injury (IRI) results in profound allograft damage during liver transplantation. The process of IRI results in adenosine triphosphatase (ATP) depletion, the production of reactive oxygen species, and progressive tissue destruction. This injury process is accelerated on reperfusion in the recipient. Over the last decade an increasing body of literature has identified a complex interplay of molecular and cellular pathways responsible for causing IRI. This article summarizes recent developments, drawing on preclinical and clinical studies, focusing on how the detrimental effects of IRI can be prevented in liver transplantation. We present a balanced overview on how machine preservation technologies, the coagulation system, antioxidants, cytoprotective agents, cytokines, preservation solutions, and the innate and adaptive immune system can be targeted to prevent IRI in liver transplantation.

Original publication

DOI

10.1016/j.transproceed.2013.04.004

Type

Journal article

Journal

Transplant Proc

Publication Date

07/2013

Volume

45

Pages

2083 - 2092

Keywords

Animals, Cold Ischemia, Cytoprotection, Graft Survival, Humans, Liver Transplantation, Reperfusion Injury, Treatment Outcome, Warm Ischemia