Published online Jan 28, 2016. doi: 10.3748/wjg.v22.i4.1551
Peer-review started: April 19, 2015
First decision: October 14, 2015
Revised: October 20, 2015
Accepted: November 9, 2015
Article in press: November 9, 2015
Published online: January 28, 2016
This review aims at evaluating the existing evidence regarding post reperfusion syndrome, providing a description of the pathophysiologic mechanisms involved and possible management and preventive strategies. A PubMed search was conducted using the MeSH database, “Reperfusion” AND “liver transplantation” were the combined MeSH headings; EMBASE and the Cochrane library were also searched using the same terms. 52 relevant studies and one ongoing trial were found. The concept of post reperfusion syndrome has evolved through years to a multisystemic disorder. The implications of the main organ, recipient and procedure related factors in the genesis of this complex syndrome are discussed in the text as the novel pharmacologic and technical approaches to reduce its incidence. However the available evidence about risk factors, physiopathology and preventive measures is still confusing, the presence of two main definitions and the numerosity of possible confounding factors greatly complicates the interpretation of the studies.
Core tip: Post reperfusion syndrome (PRS) is a serious intraoperative complication of liver transplantation that can influence recipient’s morbidity and mortality. This review provides a description of the evolution throughout the years of the concept of PRS, and gathers the existing evidence regarding the pathophysiologic mechanisms involved and the possible management and preventive strategies.