Ischemia/reperfusion injury of the liver: pathophysiologic hypotheses and potential relevance to human hypoxic hepatitis

For the last decade, numerous experimental studies have demonstrated that t he main part of liver injury caused by low or no flow states does not occur at the time of hypoxia, but during reperfusion, These experimental studies have a crucial clinical impact, because ischemia/reperfusion injury is inv olved in situations such as temporary vascular exclusion during liver surge ry for trauma or tumors, preservation injury before liver transplantation, and liver cell necrosis observed in hypoxic (ischemic) hepatitis. The aim o f the present review is to clarify the sequence of pathophysiological event s responsible for ischemia/reperfusion injury of the liver, and to examine the potential contribution of liver ischemia/reperfusion injury to the synd rome of human hypoxic hepatitis.