Past and future approaches to ischemia-reperfusion lesion associated with liver transplantation

Ischemia-reperfusion (I/R) injury associated with liver transplantation remains a serious complication in clinical practice, in spite of several attempts to solve the problem. The present review focuses on the complexity of I/R injury, summarizing conflicting results obtained from the literature abo...

Full description

Saved in:
Bibliographic Details
Published in:Life sciences (1973) 2006-10, Vol.79 (20), p.1881-1894
Main Authors: Casillas-Ramírez, Araní, Mosbah, Ismail Ben, Ramalho, Fernando, Roselló-Catafau, Joan, Peralta, Carmen
Format: Article
Language:English
Subjects:
Gene therapy
Humans
Ischemia-reperfusion
Ischemic preconditioning
Liver - blood supply
Liver - drug effects
Liver - pathology
Liver Transplantation
Organ Preservation Solutions - pharmacology
Pharmacological strategies
Preservation solutions
Reperfusion Injury - etiology
Reperfusion Injury - prevention & control
Reperfusion Injury - therapy
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Ischemia-reperfusion (I/R) injury associated with liver transplantation remains a serious complication in clinical practice, in spite of several attempts to solve the problem. The present review focuses on the complexity of I/R injury, summarizing conflicting results obtained from the literature about the mechanisms responsible for it. We also review the therapeutic strategies designed in past years to reduce I/R injury, attempting to explain why most of them have not been applied clinically. These strategies include improvements in pharmacological treatments, modifications of University of Wisconsin (UW) preservation solution based on a variety of additives, and gene therapy. Finally, we will consider new potential protective strategies using trimetazidine, 5-amino-4-imidazole carboxamide riboside (AICAR), melatonin, modulators of the renin-angiotensin system (RAS) and the phosphatidylinositol-3-OH kinase (PI3K)-Akt and the p42/p44 extracellular signal-regulated kinases (Erk 1/2) pathway. These strategies have shown promising results for I/R injury but have not been tested in experimental liver transplantation to date. Moreover, we will review ischemic preconditioning, taking into account the recent clinical studies that suggest that this surgical strategy could be appropriate for liver transplantation.
ISSN:0024-3205
1879-0631
DOI:10.1016/j.lfs.2006.06.024