Siriussawakul Arunotai, Chen Lucinda I, Lang John D
Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
J Transplant. 2012;2012:819382. doi: 10.1155/2012/819382. Epub 2012 May 7.
Ischemia reperfusion injury (IRI) is an inevitable clinical consequence in organ transplantation. It can lead to early graft nonfunction and contribute to acute and chronic graft rejection. Advanced molecular biology has revealed the highly complex nature of this phenomenon and few definitive therapies exist. This paper reviews factors involved in the pathophysiology of IRI and potential ways to attenuate it. In recent years, inhaled nitric oxide, carbon monoxide, and hydrogen sulfide have been increasingly explored as plausible novel medical gases that can attenuate IRI via multiple mechanisms, including microvascular vasorelaxation, reduced inflammation, and mitochondrial modulation. Here, we review recent advances in research utilizing inhaled nitric oxide, carbon monoxide, and hydrogen sulfide in animal and human studies of IRI and postulate on its future applications specific to solid organ transplantation.
缺血再灌注损伤（IRI）是器官移植中不可避免的临床后果。它可导致早期移植物无功能，并促成急性和慢性移植物排斥反应。先进的分子生物学揭示了这一现象的高度复杂性，且几乎没有确定性的治疗方法。本文综述了IRI病理生理学中涉及的因素以及减轻IRI的潜在方法。近年来，吸入一氧化氮、一氧化碳和硫化氢作为可能的新型医用气体受到越来越多的探索，它们可通过多种机制减轻IRI，包括微血管舒张、减轻炎症和线粒体调节。在此，我们综述了在IRI的动物和人体研究中利用吸入一氧化氮、一氧化碳和硫化氢的研究进展，并推测其在实体器官移植中的未来应用。
