Liver ischemia and reperfusion injury. Pathophysiology and new horizons in preconditioning and therapy
Liver ischemia and reperfusion injury. Pathophysiology and new horizons in preconditioning and therapy
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DOI：
10.1590/s0102-865020180080000008
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发表时间：
2018-08-01
期刊：
影响因子：
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通讯作者：
Castro-e-Silva, Orlando
中科院分区：
文献类型：
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作者：
Nakazato, Paula Carolina Grande;Victorino, João Paulo;Castro-e-Silva, Orlando
众所周知，在肝脏手术过程中，为了避免可能的出血、输血、强度变化及其短期和长期后果，经常中断冲洗是至关重要的。过去人们认为气流中断不应超过20分钟，这限制了这种机动的使用。然而，在健康的肝脏中，缺血可以维持60分钟以上。本论文综述包括：1)简要介绍，以证明综述设计的基本原理；2)肝脏缺血再灌注损伤三个阶段的病理生理方面；3)先天免疫和获得性免疫；4)氧化应激；5)细胞凋亡和自噬，一些重要的生物标志物（肿瘤坏死因子-a、一氧化氮、金属蛋白酶）；最后;6)预防（“欺骗”）策略，治疗肝IR损伤的非药物和药物选择。
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-a, nitric oxide, metalloproteinases); and, finally; 6) Preventive ("cheating") strategies, non-pharmacological and pharmacological options to treat the liver IR injury.