Cellular and Molecular Mechanisms in Perioperative Hepatic Protection: A Review of Current Interventions

authors:

avatar Zahra Talebi 1 , * , avatar Hassan Peyvandi ORCID 2 , avatar Ali Dabbagh ORCID

Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
MD, Associate Professor, Clinical Research Development Center, Loghman Hakim Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Journal of Cellular & Molecular Anesthesia: Vol.2, issue 2; e149530
article type: Review
DOI: https://doi.org/10.22037/jcma.v2i2.14839

how to cite: Talebi Z, Peyvandi H, Dabbagh A. Cellular and Molecular Mechanisms in Perioperative Hepatic Protection: A Review of Current Interventions. J Cell Mol Anesth. 2017;2(2):e149530. https://doi.org/10.22037/jcma.v2i2.14839.

Abstract

Liver is one of the most important organs needing great concern during the perioperative period. There are a number of different mechanisms that interact with liver cells and might affect their integrity and cell live. Though these mechanisms are not all the same, there is a great common point: all affect the metabolic pathways of the liver. Ischemia, anesthetic drug effects and other perioperative insults may affect the liver. Disturbance in an organ?s blood flow is an inherent part of diverse surgical procedures, which leads to lack of oxygen and nutrient supply. These ischemic periods can be particularly long in case of liver surgeries, such as resection of large hepatic tumors, management of hepatic trauma and liver transplant. Once the blood flow and oxygen supply are restored, the interruption of blood flow affects the oxygen dependent cells in liver, which require mitochondrial oxidative phosphorylation for their metabolism. Molecular mechanisms such as Redox status, ionic interchange disturbances as well as different mediators and cells like KC, SEC, dendritic cells, leukocytes, and lymphocytes, are involved in the process ultimately leading to cell death by apoptosis and necrosis. This review provides an overview on the cellular and molecular mechanisms involved in liver injuries, categorizing these mechanisms in 3 different classes: preoperative mechanisms, intraoperative mechanisms and postoperative mechanisms. Each of them are discussed in a different part of the manuscript