Ischaemia-reperfusion injury, in liver transplantation-from bench to bedside

被引:696
作者
Zhai, Yuan [1 ]
Petrowsky, Henrik [1 ]
Hong, Johnny C. [1 ]
Busuttil, Ronald W. [1 ]
Kupiec-Weglinski, Jerzy W. [1 ]
机构
[1] Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Dumont UCLA Transplant Ctr,Div Liver & Pancreas T, Los Angeles, CA 90095 USA
关键词
TOLL-LIKE-RECEPTOR; HEPATIC ISCHEMIA/REPERFUSION INJURY; SELECTIN GLYCOPROTEIN LIGAND-1; MOLECULAR-PATTERN MOLECULES; T-CELL; COLD ISCHEMIA/REPERFUSION; ENDOGENOUS LIGANDS; INFLAMMATORY RESPONSES; ORGAN PRESERVATION; IMMUNE-RESPONSE;
D O I
10.1038/nrgastro.2012.225
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Ischaemia-reperfusion injury (IRI in the liver, a major complication of haemorrhagic shock, resection and transplantation, is a dynamic process that involves the two interrelated phases of local ischaemic insult and inflammation-mediated reperfusion injury. This Review highlights the latest mechanistic insights into innate-adaptive immune crosstalk and cell activation cascades that lead to inflammation-mediated injury in livers stressed by ischaemia-reperfusion, discusses progress in large animal experiments and examines efforts to minimize liver IRI in patients who have received a liver transplant. The interlinked signalling pathways in multiple hepatic cell types, the IRI kinetics and positive versus negative regulatory loops at the innate-adaptive immune interface are discussed. The current gaps in our knowledge and the pathophysiology aspects of IRI in which basic and translational research is still required are stressed. An improved appreciation of cellular immune events that trigger and sustain local inflammatory responses, which are ultimately responsible for organ injury, is fundamental to developing innovative strategies for treating patients who have received a liver transplant and developed ischaemia-reperfusion inflammation and organ dysfunction.
引用
收藏
页码:79 / 89
页数:11
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