Department of Anesthesiology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
Department of Surgery, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
Int J Mol Sci. 2021 Mar 8;22(5):2727. doi: 10.3390/ijms22052727.
Ischemia reperfusion injury (IRI) is inevitable in kidney transplantation and negatively impacts graft and patient outcome. Reperfusion takes place in the recipient and most of the injury following ischemia and reperfusion occurs during this reperfusion phase; therefore, the intra-operative period seems an attractive window of opportunity to modulate IRI and improve short- and potentially long-term graft outcome. Commonly used volatile anesthetics such as sevoflurane and isoflurane have been shown to interfere with many of the pathophysiological processes involved in the injurious cascade of IRI. Therefore, volatile anesthetic (VA) agents might be the preferred anesthetics used during the transplantation procedure. This review highlights the molecular and cellular protective points of engagement of VA shown in in vitro studies and in vivo animal experiments, and the potential translation of these results to the clinical setting of kidney transplantation.
缺血再灌注损伤（IRI）在肾移植中不可避免，会对移植物和患者的预后产生负面影响。再灌注发生在受者体内，缺血再灌注后大部分损伤发生在再灌注阶段；因此，围手术期似乎是一个有吸引力的机会窗口，可以调节 IRI 并改善短期和潜在的长期移植物预后。已证实常用的挥发性麻醉剂（如七氟醚和异氟醚）会干扰 IRI 损伤级联反应中涉及的许多病理生理过程。因此，挥发性麻醉剂（VA）可能是移植过程中首选的麻醉剂。这篇综述强调了在体外研究和体内动物实验中 VA 显示出的分子和细胞保护作用的切入点，以及这些结果向肾移植临床环境转化的潜力。
