Kenneth J. Dery, Fady Kaldas, Jerzy W. Kupiec-Weglinski
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Abstract
Background
Hepatic ischemia-reperfusion injury (HIRI) is a multifaceted pathophysiological process involving a cascade of interconnected cellular events. The initial ischemic stress, followed by the reestablishment of blood circulation to the liver, triggers a feed-forward innate immune-driven response that exacerbates the hepatocellular injury. HIRI poses a significant clinical challenge in liver transplantation (LT), as it can result in tissue damage, organ dysfunction, and poor clinical outcomes.
Methods and results
This review highlights current key issues in HIRI translational research, as revealed by recent bibliometric studies. It examines the mechanisms that facilitate homeostatic regulation after HIRI. Additionally, it addresses refined pharmacological strategies aimed at mitigating oxidative stress and inflammation. Hot topic areas in HIRI research include autophagy, donation after circulatory death, and NLRP3-dependent inflammasome activation following LT. New pharmacological agents, such as anti-oxidative compounds, metabolic modulators, and plant-derived compounds, are being explored to influence inflammatory responses. There is a strong clinical emphasis on broadening the donor pool by utilizing marginal donor grafts and advanced machine perfusion techniques. Enhancing translational research through the development of human-relevant organoids or ex vivo liver perfusion systems is essential for connecting laboratory discoveries with clinical practices in life-saving surgical procedures.
Conclusion
A comprehensive approach that emphasizes the regulatory mechanisms of cellular responses to oxygen stress and immune cell activation, alongside innovative donor organ preservation, like machine perfusion, will shape the future direction of HIRI research by enhancing graft viability and revitalizing suboptimal donor organs.
期刊介绍：
To provide to national and regional audiences experiences unique to them or confirming of broader concepts originating in large controlled trials. All aspects of organ, tissue and cell transplantation clinically and experimentally. Transplantation Reports will provide in-depth representation of emerging preclinical, impactful and clinical experiences. -Original basic or clinical science articles that represent initial limited experiences as preliminary reports. -Clinical trials of therapies previously well documented in large trials but now tested in limited, special, ethnic or clinically unique patient populations. -Case studies that confirm prior reports but have occurred in patients displaying unique clinical characteristics such as ethnicities or rarely associated co-morbidities. Transplantation Reports offers these benefits: -Fast and fair peer review -Rapid, article-based publication -Unrivalled visibility and exposure for your research -Immediate, free and permanent access to your paper on Science Direct -Immediately citable using the article DOI
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