Post reperfusion syndrome during liver transplantation: From pathophysiology to therapy and preventive strategies

World J Gastroenterol. 2016 Jan 28;22(4):1551-69. doi: 10.3748/wjg.v22.i4.1551.

Abstract

This review aims at evaluating the existing evidence regarding post reperfusion syndrome, providing a description of the pathophysiologic mechanisms involved and possible management and preventive strategies. A PubMed search was conducted using the MeSH database, "Reperfusion" AND "liver transplantation" were the combined MeSH headings; EMBASE and the Cochrane library were also searched using the same terms. 52 relevant studies and one ongoing trial were found. The concept of post reperfusion syndrome has evolved through years to a multisystemic disorder. The implications of the main organ, recipient and procedure related factors in the genesis of this complex syndrome are discussed in the text as the novel pharmacologic and technical approaches to reduce its incidence. However the available evidence about risk factors, physiopathology and preventive measures is still confusing, the presence of two main definitions and the numerosity of possible confounding factors greatly complicates the interpretation of the studies.

Keywords: Drug therapy; Hemodynamics; Ischemia-reperfusion injury; Liver transplantation; Reperfusion.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Hemodynamics*
  • Humans
  • Liver Circulation*
  • Liver Transplantation / adverse effects*
  • Models, Animal
  • Reperfusion Injury / etiology*
  • Reperfusion Injury / physiopathology
  • Reperfusion Injury / prevention & control
  • Risk Factors
  • Treatment Outcome