Author/Authors :
Nakazato, Paula Carolina Grande Surgery and Anatomy Department - Medical School - Universidade de São Paulo (USP), Ribeirao PretoSP, Brazil , Victorino, João Paulo USP, Ribeirao Preto-SP, Brazil , Fina, Clarice Fleury Surgery and Anatomy Department - Medical School - USP, Ribeirao Preto-SP, Brazil , Mendes, Karina Dal Sasso General and Specialized Nursing Department - USP, Ribeirao Preto-SP, Brazil , Gomes, Maria Cecília Jordani Surgery and Anatomy Department - Medical School - USP, Ribeirao Preto-SP, Brazil , Evora, Paulo Roberto Barbosa Surgery and Anatomy Department - Medical School - USP, Ribeirao Preto-SP, Brazil , D’Albuquerque, Luiz Augusto Carneiro Department of Gastroenterology - Medical School - USP, Ribeirao Preto-SP, Brazil , Castro-e-Silva, Orlando Surgery and Anatomy Department - Medical School - USP, Ribeirao Preto-SP, Brazil
Abstract :
It is well known that during hepatic operative procedures, it is often critical that the irrigation is interrupted to avoid possible bleeding, blood transfusions, variable intensities, and their short and long-term consequences. It was believed in the past that the flow interruption should not exceed 20 minutes, which limited the use of this maneuver. However, it has been postulated that ischemia could be maintained for more than 60 minutes in healthy livers. The present paper review includes: 1) A brief introduction to justify the rationale of the review design; 2) Aspects of the pathophysiology of the three stages of the liver ischemia-reperfusion injury; 3) The innate and acquired immunity; 4) Oxidative stress; 5) Apoptosis and autophagy, Some essential biomarkers (Tumor Necrosis Factor-α, nitric oxide, metalloproteinases); and, finally; 6) Preventive (“cheating”) strategies, non-pharmacological and pharmacological options to treat the liver IR injury.
