Current status of ischemia and reperfusion injury in the liver

Ischemia/reperfusion (I/R) injury is a major obstacle affecting graft function after liver transplantation. The cause of this injury is multifactorial. A detailed understanding of the mechanisms involved in I/R injury is important for the design of effective therapeutic agents to ameliorate this process and improve outcome after transplantation. Increasing experimental evidence has suggested that Kupffer cells, neutrophils, endothelial cells, and reactive oxygen species can contribute significantly to the pathogenesis of I/R injury. This review serves as an overview of the role of these important mediators in I/R injury. A general introduction of the histopathological and microcirculatory changes occurring in response to I/R is presented. Therapeutic interventions that have been developed to reduce hepatic I/R injury, which target various steps in this cascade of events, is also provided.