Surgery Today

, Volume 44, Issue 9, pp 1611–1625

Ischemia–reperfusion injury in patients with fatty liver and the clinical impact of steatotic liver on hepatic surgery

  • Hirotaka Tashiro
  • Shintaro Kuroda
  • Yoshihiro Mikuriya
  • Hideki Ohdan
Review Article

DOI: 10.1007/s00595-013-0736-9

Cite this article as:
Tashiro, H., Kuroda, S., Mikuriya, Y. et al. Surg Today (2014) 44: 1611. doi:10.1007/s00595-013-0736-9

Abstract

Hepatic steatosis is one of the most common hepatic disorders in developed countries. The epidemic of obesity in developed countries has increased with its attendant complications, including metabolic syndrome and non-alcoholic fatty liver disease. Steatotic livers are particularly vulnerable to ischemia/reperfusion injury, resulting in an increased risk of postoperative morbidity and mortality after liver surgery, including liver transplantation. There is growing understanding of the molecular and cellular mechanisms and therapeutic approaches for treating ischemia/reperfusion injury in patients with steatotic livers. This review discusses the mechanisms underlying the susceptibility of steatotic livers to ischemia/reperfusion injuries, such as mitochondrial dysfunction and signal transduction alterations, and summarizes the clinical impact of steatotic livers in the setting of hepatic resection and liver transplantation. This review also describes potential therapeutic approaches, such as ischemic and pharmacological preconditioning, to prevent ischemia/reperfusion injury in patients with steatotic livers. Other approaches, including machine perfusion, are also under clinical investigation; however, many pharmacological approaches developed through basic research are not yet suitable for clinical application.

Keywords

Steatotic liver Ischemia–reperfusion injury Rho-kinase 

Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Hirotaka Tashiro
    • 1
  • Shintaro Kuroda
    • 1
  • Yoshihiro Mikuriya
    • 1
  • Hideki Ohdan
    • 1
  1. 1.Department of Gastroenterological and Transplant SurgeryHiroshima University HospitalHiroshimaJapan

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