School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China.
Clin Mol Hepatol. 2024 Oct;30(4):585-619. doi: 10.3350/cmh.2024.0222. Epub 2024 Jul 1.
Hepatic ischemia‒reperfusion injury (HIRI) is a common and inevitable complication of hepatic trauma, liver resection, or liver transplantation. It contributes to postoperative organ failure or tissue rejection, eventually affecting patient prognosis and overall survival. The pathological mechanism of HIRI is highly complex and has not yet been fully elucidated. The proposed underlying mechanisms include mitochondrial damage, oxidative stress imbalance, abnormal cell death, immune cell hyperactivation, intracellular inflammatory disorders and other complex events. In addition to serious clinical limitations, available antagonistic drugs and specific treatment regimens are still lacking. Therefore, there is an urgent need to not only clarify the exact etiology of HIRI but also reveal the possible reactions and bottlenecks of existing drugs, helping to reduce morbidity and shorten hospitalizations. We analyzed the possible underlying mechanism of HIRI, discussed various outcomes among different animal models and explored neglected potential therapeutic strategies for HIRI treatment. By thoroughly reviewing and analyzing the literature on HIRI, we gained a comprehensive understanding of the current research status in related fields and identified valuable references for future clinical and scientific investigations.
肝缺血再灌注损伤(HIRI)是肝外伤、肝切除或肝移植后常见且不可避免的并发症。它导致术后器官衰竭或组织排斥,最终影响患者的预后和总体生存率。HIRI 的病理机制非常复杂,尚未完全阐明。提出的潜在机制包括线粒体损伤、氧化应激失衡、异常细胞死亡、免疫细胞过度激活、细胞内炎症紊乱等复杂事件。除了严重的临床局限性外,目前还缺乏拮抗药物和特定的治疗方案。因此,不仅需要阐明 HIRI 的确切病因,还需要揭示现有药物的可能反应和瓶颈,以降低发病率并缩短住院时间。我们分析了 HIRI 的可能潜在机制,讨论了不同动物模型中的各种结果,并探讨了 HIRI 治疗中被忽视的潜在治疗策略。通过对 HIRI 相关文献进行全面审查和分析,我们全面了解了相关领域的研究现状,并为未来的临床和科学研究提供了有价值的参考文献。