Department of General, Vascular and Oncological Surgery, Medical University of Warsaw, Stępińska Street 19/25, 00-739 Warsaw, Poland.
Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha Street 1A, 02-097 Warsaw, Poland.
Int J Mol Sci. 2021 Jul 30;22(15):8229. doi: 10.3390/ijms22158229.
Hepatocellular carcinoma (HCC) is one of the most frequent indications for liver transplantation. However, the transplantation is ultimately associated with the occurrence of ischemia-reperfusion injury (IRI). It affects not only the function of the graft but also significantly worsens the oncological results. Various methods have been used so far to manage IRI. These include the non-invasive approach (pharmacotherapy) and more advanced options encompassing various types of liver conditioning and machine perfusion. Strategies aimed at shortening ischemic times and better organ allocation pathways are still under development as well. This article presents the mechanisms responsible for IRI, its impact on treatment outcomes, and strategies to mitigate it. An extensive review of the relevant literature using MEDLINE (PubMed) and Scopus databases until September 2020 was conducted. Only full-text articles written in English were included. The following search terms were used: "ischemia reperfusion injury", "liver transplantation", "hepatocellular carcinoma", "preconditioning", "machine perfusion".
肝细胞癌（HCC）是肝移植最常见的适应证之一。然而，移植最终会导致缺血再灌注损伤（IRI）。它不仅影响移植物的功能，而且还显著恶化肿瘤学结果。迄今为止，已经使用了各种方法来管理IRI。这些方法包括非侵入性方法（药物治疗）和更先进的选择，包括各种类型的肝脏预处理和机器灌注。旨在缩短缺血时间和更好的器官分配途径的策略也在不断发展中。本文介绍了IRI 的发生机制、对治疗结果的影响以及减轻IRI 的策略。使用 MEDLINE（PubMed）和 Scopus 数据库对截至 2020 年 9 月的相关文献进行了广泛的综述。仅纳入了全文为英文的文章。使用了以下搜索词：“缺血再灌注损伤”、“肝移植”、“肝细胞癌”、“预处理”、“机器灌注”。
