Karaciğer iskemi reperfüzyon hasarı

Travma, safra yolu tam veya kısmi tıkanmaları, kanser, karaciğer naklinden sonra, ayrıca cerrahi girişim olmaksızın bir hemodinamik veya kardiyojenik şok periyodunu takiben karaciğer iskemisi oluşabilmektedir. Karaciğer iskemi reperfüzyon hasan patofizyolojisinde Kupffer hücre aktivasyonu, reaktif oksijen türevlerinin oluşumu, sitokin ve kemokin salınımı, vazokonstrüksiyon, nitrik oksit ve endotelin den¬gesindeki bozulma, nötrofil lökositlerin toplanması, mitokondria geçirgenliğinin değişikliğe uğraması ve pH paradoksu gibi çeşitli hücresel ve moleküler mekanizmalar önemli rol oynar. Bu karmaşık mekanizmalar hücre ölümüne, organ fonksiyon bozukluğuna ve en sonunda da organ kaybına neden olmaktadır.

Anahtar Kelimeler:

Sitokinler, Nitrik oksit, Oksidatif stres, İskemi, Karaciğer, Reperfüzyon hasarı, Enflamasyon medyatörleri, Kemokinler, Endotelinler

Ischemia reperfusion injury in liver

Hepatic ischemia can occur after trauma, biliary trackt complete of partial obstructions, cancer, liver transplantation, and also hemodynamic and cardiogenic shock periods without surgical operations. Various cellular and molecular interactions such as Kupffer cell activation, formation of reactive oxygen species, cytokine and chemokine release, vasoconstriction, imbalance of nitricoxyde and endothelin concentration, aggregation and migration of neutrophils, altered mitochondrial permeability and pH paradox can play an important role in pathophysiology of hepatic ischemia reperfusion injury. These complex mechanisms can lead to cell death, organ dysfunction and finally organ loss.

Keywords:

Cytokines, Nitric Oxide, Oxidative Stress, Ischemia, Liver, Reperfusion Injury, Inflammation Mediators, Chemokines, Endothelins,

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