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Title: | Hepatic microcirculatory failure Falência microcirculatória hepática |
Keywords: | Liver Ischemia-Reperfusion Injury Steatosis Microcirculation |
Publisher: | Sociedade Brasileira para Desenvolvimento Pesquisa em Cirurgia |
Description: | Liver ischemia has been considered a frequent problem in medical practice, and can be associated to a number of surgical and clinical situations, such as massive hepatic resections, sepsis, liver trauma, circulatory shock and liver transplantation. After restoring blood flow, the liver is further subjected to an additional injury more severe than that induced by ischemia. On account of the complexity of mechanisms related to pathophysiology of ischemia and reperfusion (I/R) injury, this review deals with I/R effects on sinusoidal microcirculation, especially when steatosis is present. Alterations in hepatic microcirculation are pointed as a main factor to explain lower tolerance of fatty liver to ischemia-reperfusion insult. The employment of therapeutic strategies that interfere directly with vasoactive mediators (nitric oxide and endothelins) acting on the sinusoidal perfusion seem to be determinant for the protection of the liver parenchyma against I/R. These approaches could be very suitable to take advantage of marginal specimens as fatty livers, in which the microcirculatory disarrangements hamper its employment in liver transplantation. Supported by The Ministerio de Educación y Ciencia (Project grant nº BFI 2003-00912, SAF 2005-00385, and Ramón y Cajal research contract to Carmen Peralta) (Madrid, España), Ministerio de Asuntos Exteriores (HP2003-0051) and Generalitat de Catalunya (project 2005SGR/00781). The authors thank to CAPES – Ministério da Educação (Brasília, Brasil) and to AECI/MAEC (Madrid, España) for the research support for F.S. Ramalho and I. Fernandez-Monteiro, respectively. Peer reviewed |
URI: | http://dspace.mediu.edu.my:8181/xmlui/handle/10261/2176 |
Other Identifiers: | Acta Cirurgica Brasilera, 21(Suppl.1): 48-53 (2006) 0102-8650 http://hdl.handle.net/10261/2176 |
Appears in Collections: | Digital Csic |
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