Purpose and Methods　Open-heart surgery with the use of cardiopulmonary bypass (CPB) is associated with an inflammatory cascade which contributes to the development of postoperative complications including multiple organ failure. To provide an update on the subject, we briefly review the recent English-language literature.Results　During CPB, various factors have been recognized to induce a complex inflammatory response. Based on an enhanced understanding of the underlying mechanisms, therapeutic strategies have been developed to reduce this inflammatory reaction and its subsequent damaging effects. Off-pump coronary artery bypass grafting may result in less inflammatory injury as compared with the conventional maneuver, which can in turn, diminish the incidence of cardiac, renal, or neurological dysfunction. It is also clear that improving the biocompatibility of CPB materials can lead to a better patient recovery. Inasmuch as the pathophysiology involved appears to be multifactorial, it is unlikely that a single intervention could achieve the desired goal. Both pharmacologic strategies, such as steroid pretreatment, and modification of mechanical devices, such as the use of heparin-coated CPB circuits, could have important clinical implications. The balance between pro- and anti-inflammatory responses may be crucial in limiting the extent of inflammatory injury. Conclusions　To date, the concept of organ protection should no longer be limited to the individual organ. Instead, investigations must be extended to focus on a systemic level.

Objective:It has been proposed that blood pressure variability(BPV) is positively related to end-organ damage(EOD) in hypertension.The present work was designed to observe the effects of long-term treatment with nitrendipine and hydralazine on BPV and EOD in spontaneously hypertensive rats(SHR),to examine the hypothesis that lowering BPV with an antihypertensive drug is an important factor in organ protection.Design and methods:Drugs were mixed in rat chow.After 4 months of drug administration,blood pressure was recorded continuously in conscious freely moving rats for 24 h.The heart,kidneys,and brain were then isolated and examined.Results:It was found that nitrendipine significantly decreased blood pressure and BPV,and significantly decreased EOD score in SHR.Hydralazine decreased blood pressure,but did not lower BPV.No effect on EOD was found in hydralazine-treated rats.In control rat(n=38),EOD score was weakly related to systolic blood pressure(r=0.331,P<0.05) and closely related to long-term systolic BPV(r=0.551,P<0.01).In nitrendipine-treated rats,EOD score was closely related to long-term systolic BPV(r=0.602,P<0.01),but not to blood pressure level(r=0.174,P>0.05).Conclusion:BPV plays an important role in the organ-protecting effects of nitrendipine.

BACKGROUND:?Liver? transplantation? is? the? therapy? of?choice?for?patients?with?end-stage?liver?diseases.?However,?the?gap?between?the?low?availability?of?organs?and?high?demand?is? continuously? increasing.? Innovative? strategies? for? organ?protection?are?necessary?to?expand?donor?pool?and?to?achieve?better?outcomes?for?liver?transplantation.?The?present?review?analyzed?and?compared?various?strategies?of?liver?protection.
DATA?SOURCES:?Databases?such?as?PubMed,?Embase?and?Ovid?were?searched?for?the?literature?related?to?donor?liver?protection?strategies? using? following? key? words:? "ischemia? reperfusion?injury",?"graft?preservation",?"liver?transplantation",?"machine?perfusion"? and? "conditioning".? Of? the? 146? studies? identified,?only?those?with?cutting?edge?strategies?were?analyzed.
RESULTS:?A?variety?of?therapeutic?approaches?were?proposed?to?alleviate?graft?ischemia/reperfusion?injury,?which?included?static?cold?storage,?machine?perfusion?(hypothermic,?normo-thermic? and? subnormothermic),? manual? conditioning? (pre,?post? and? remote),? and? pharmacological? conditioning.? Evi-dences?from?animal?experiments?and?clinical?trials?suggested?that? all? these? strategies? could? potentially? protect? liver? graft;?however,?their?clinical?applications?are?limited?partially?due?to?their?own?disadvantages.
CONCLUSIONS:?There? are? a? plenty? of? methods? suggested?to?decrease?the?degree?of?donor?liver?transplantation-related?injury.?However,?none?of?these?approaches?is?perfect?in?clinical?practice.? More? translational? researches? (molecular? and? clini-cal?studies)?are?needed?to?improve?the?techniques?in?liver?graft?protection.