Dilemma of Hepatic Ischemia Reperfusion Injury after Liver Transplantation

Liver transplantation, whether from a deceased or living donor (LDLT), is still a definite line of treatment for decompensated cirrhosis, early stage of hepatocellular carcinoma, and acute liver failure. Organs from living donors offer many potential advantages over organs from deceased donors; the most important is the optimization of the timing of transplantation. Also preservation time is minimal, so there is significantly less ischemic damage. Time-zero biopsies sampled after graft revascularization predicts adverse clinical outcomes after liver transplantation. It is well known that severe Ischemia/reperfusion injury (IRI) signals the likely need for early retransplantation. This fact emphasizes the value of the time –zero biopsy sampled immediately after graft reperfusion. Hepatic Ischemia-Reperfusion Injury after Liver Transplantation is a common and major complication after liver surgery and transplantation. It impairs liver function, increases postoperative morbidity and mortality, interferes with recovery and thus has a major impact on clinical outcomes.