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Repair and Regeneration After Important Visceral Injury

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Regenerative Medicine in China

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Abstract

Visceral organs are the participants and maintainers of various life activities of the body. Various injuries such as trauma, surgery, organ transplantation, inflammatory bowel disease, and other serious diseases will cause damage to internal organs. The main reason is the double impact of ischemia and reperfusion, which in turn causes the activation of complement-phagocytic-lymphocyte in the body, causing local and systemic inflammatory reactions, dysfunction of coagulation system, hypermetabolic status, etc., eventually leading to multiple organ dysfunction syndrome (MODS), and even multiple systemic organ failure (MSOF) also called multiple organ failure (MOF). Visceral organ damage, especially multiple organ function damage, is an important feature of the aggravation of traumatic injury and the occurrence of complications. For open wounds, damaged organs can be repaired and reconstructed by surgery. However, for closed injury such as ischemia-reperfusion injury to intestine, liver, kidney, and lung; ischemic injury of donors during organ transplantation; and multiple organ damage after traumatic (burn) injury, especially the occult shock of the intestinal tract, etc., the organ itself has ischemic damage that is difficult to distinguish with the naked eye; the pathogenesis of such damage is complex, wide, and concealed; there is a lack of effective prosthetic measures; and the repair after injury is often not easy to attract people’s attention, thus leading to the death of patients. According to experts’ statistics, more than half of all deaths are caused by visceral complications after severe burns; two-thirds of the injured in serious traffic accidents are accompanied by visceral injury, which is the primary cause of disability and death. MODS is also ranked first in the cause of death in the intensive care unit. In general, the death of the visceral injury after severe trauma is mainly divided into two stages: early death, which is closely related to shock or severe brain injury; and late death, which is mainly caused by MODS or multiple system organ failure (MSOF), and its occurrence is associated with systemic inflammatory response syndrome (SIRS), ischemia-reperfusion injury, and endotoxemia. Among them, organ ischemia-reperfusion injury and microcirculatory dysfunction (the second hit) are one of the central links of visceral complications after severe trauma. For visceral injury, previous studies focused on the pathogenesis of visceral injury and initially clarified the role of infection, uncontrolled inflammatory response, and oxygen-free radical activation in the occurrence of severe visceral injury. However, it is worth noting that previous studies have focused too much on the pathogenesis of organ damage, while there is a lack of in-depth discussion on the outcome of damaged organs. Therefore, it is essential to strengthen the prevention and treatment of visceral injuries and promote the early repair and reconstruction of damaged organs to guarantee life safety. How to accelerate and promote the repair of damaged internal organs has become the key to determine the success of serious trauma treatment, especially to prevent MODS and MSOF.

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Authors and Affiliations

  1. General Hospital of Southern Theater Command of Chinese People’s Liberation Army, Guangzhou, China

    Biao Cheng

  2. The Chinese People’s Liberation Army General Hospital, Beijing, China

    Xiaobing Fu & Shuyong Wang

  3. State Key Laboratory of Trauma, Burns and Combined Injury, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, China

    Jianxin Jiang, Ce Yang & Haisheng Li

  4. Academy of Military Medical Sciences, Military Medical Research Institute, Beijing, China

    Yunfang Wang

  5. Shenzhen People’s Hospital, The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen, China

    Yuesheng Huang

  6. Department of Neurobiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China

    Xiaoguang Li, Zhaoyang Yang, Hongmei Duan, Wen Zhao, Yudan Gao & Peng Hao

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    Xiaobing Fu

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Cheng, B. et al. (2021). Repair and Regeneration After Important Visceral Injury. In: Fu, X. (eds) Regenerative Medicine in China. Springer, Singapore. https://doi.org/10.1007/978-981-16-1182-7_7

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