These authors contributed equally to this study.
Preconditioning, organ preservation, and postconditioning to prevent ischemia-reperfusion injury to the liver
Article first published online: 29 SEP 2009
Copyright © 2009 American Association for the Study of Liver Diseases
Volume 15, Issue 10, pages 1172–1182, October 2009
How to Cite
de Rougemont, O., Lehmann, K. and Clavien, P.-A. (2009), Preconditioning, organ preservation, and postconditioning to prevent ischemia-reperfusion injury to the liver. Liver Transpl, 15: 1172–1182. doi: 10.1002/lt.21876
- Issue published online: 29 SEP 2009
- Article first published online: 29 SEP 2009
- Manuscript Accepted: 17 JUL 2009
- Manuscript Received: 8 DEC 2008
Ischemia and reperfusion lead to injury of the liver. Ischemia-reperfusion injury is inevitable in liver transplantation and trauma and, to a great extent, in liver resection. This article gives an overview of the mechanisms involved in this type of injury and summarizes protective and treatment strategies in clinical use today. Intervention is possible at different time points: during harvesting, during the period of preservation, and during implantation. Liver preconditioning and postconditioning can be applied in the transplant setting and for liver resection. Graft optimization is merely possible in the period between the harvest and the implantation. Given that there are 3 stages in which a surgeon can intervene against ischemia-reperfusion injury, we have structured the review as follows. The first section reviews the approaches using surgical interventions, such as ischemic preconditioning, as well as pharmacological applications. In the second section, static organ preservation and machine perfusion are addressed. Finally, the possibility of treating the recipient or postconditioning is discussed. Liver Transpl 15:1172–1182, 2009. © 2009 AASLD.