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Hepatic ischemia-reperfusion syndrome and its effect on the cardiovascular system: The role of treprostinil, a synthetic prostacyclin analog

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世界胃肠外科杂志:英文版(电子版) 2023年第9期15卷 1858-1870页

作者： Christina Mouratidou Efstathios T Pavlidis Georgios Katsanos Serafeim-Chrysovalantis Kotoulas eleni mouloudi Georgios Tsoulfas Ioannis N Galanis Theodoros E Pavlidis Intensive Care Unit Hippokration General HospitalThessaloniki 54642Greece 2^(nd)Propedeutic Department of Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece Department of Transplantation Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Hepatic ischemia-reperfusion syndrome has been the subject of intensive study and experimentation in recent decades since it is responsible for the outcome of several clinical entities,such as major hepatic resections and liver *** addition to the organ’s post reperfusion injury,this syndrome appears to play a central role in the dysfunction of distant tissues and ***,continuous research should be directed toward finding effective therapeutic options to improve the outcome and reduce the postoperative morbidity and mortality *** is a synthetic analog of prostaglandin I2,and its experimental administration has shown encouraging *** has already been approved by the Food and Drug Administration in the United States for pulmonary arterial hypertension and has been used in liver transplantation,where preliminary encouraging results showed its safety and feasibility by using continuous intravenous administration at a dose of 5 ng/kg/*** improves renal and hepatic function,diminishes hepatic oxidative stress and lipid peroxidation,reduces hepatictoll-like receptor 9 and inflammation,inhibits hepatic apoptosis and restores hepatic adenosine triphosphate(ATP)levels and ATP synthases,which is necessary for functional maintenance of *** exhibits vasodilatory properties and antiplatelet activity and regulates proinflam-matory cytokines;therefore,it can potentially minimize ischemia-reperfusion ***,it may have beneficial effects on cardiovascular parameters,and much current research interest is concentrated on this compound.

关键词： Hepatic ischemia-reperfusion syndrome Myocardial damage Prostaglandins Treprostinil Liver transplantation Hepatectomy

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Enhanced recovery after surgery in liver transplantation:Challenges and feasibility

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World Journal of Transplantation 2022年第7期12卷 195-203页

作者： Georgios Katsanos Konstantina-eleni Karakasi Nikolaos Antoniadis Stella Vasileiadou Athanasios Kofinas Antonios Morsi-Yeroyannis Evangelia Michailidou Ioannis Goulis Emmanouil Sinakos Olga Giouleme Ilias Marios Oikonomou George Evlavis Georgios Tsakiris eleni Massa eleni mouloudi Georgios Tsoulfas Department of Transplantation Medical SchoolAristotle University of ThessalonikiHippokration General HospitalThessaloniki 54642Greece Intensive Care Unit National Health SystemHippokration General HospitalThessaloniki 54642Greece Fourth Department of Internal Medicine Hippokration General HospitalMedical School of Aristotle UniversityThessaloniki 54642Greece Second Propaedeutic Department of Internal Medicine Hippokratio General HospitalAristotle University ThessalonikiThessaloniki 54642Greece Nursing Department National Health SystemDepartment of TransplantationHippokration General HospitalThessaloniki 54642Greece

BACKGROUND Enhanced recovery after surgery(ERAS)started a revolution that changed age-old surgical stereotypical practices regarding the overall management of the surgical *** the last decade,ERAS has gained significant acceptance in the community of general surgery,in addition to several other surgical specialties,as the evidence of its advantages continues to *** of the last remaining fields,given its significant complexity and intricate nature,is liver transplantation(LT).AIM To investigate the existing efforts at implementing ERAS in *** We conducted a systematic review of the existing studies that evaluate ERAS in orthotopic LT,with a multimodal approach and focusing on measurable clinical primary endpoints,namely length of hospital *** All studies demonstrated a considerable decrease in length of hospital stay,with no readmission or negative impact of the ERAS protocol applied to the postoperative *** ERAS is a well-validated multimodal approach for almost all types of surgical procedures,and its future in selected LT patients seems promising,as the preliminary results advocate for the safety and efficacy of ERAS in the field of LT.

关键词： Enhanced recovery Enhanced recovery after surgery Recovery Liver transplantation Liver

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