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BioMed Research International
Volume 2013, Article ID 192029, 12 pages
Review Article

The Impact of Hepatic Steatosis on Hepatic Ischemia-Reperfusion Injury in Experimental Studies: A Systematic Review

1Department of Surgery, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
2Maurice Wilkins Centre for Biodiscovery, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
3School of Biological Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
4New Zealand Liver Transplant Unit, Auckland City Hospital, Private Bag 92024, Auckland 1023, New Zealand

Received 8 April 2013; Accepted 23 July 2013

Academic Editor: Mohamed Tarek Shata

Copyright © 2013 Michael J. J. Chu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. The impact of hepatic steatosis on outcome following hepatic ischemia-reperfusion injury (IRI) remains controversial with conflicting clinical results. A number of experimental studies have been published examining the relationship between hepatic steatosis and IRI. This systematic review evaluates these experimental studies. Methods. An electronic search of the Medline and Embase databases (January 1946 to June 2012) was performed to identify studies that reported relevant outcomes in animal models of hepatic steatosis subjected to IRI. Results. A total of 1314 articles were identified, of which 33 met the predefined criteria and were included in the study. There was large variation in the type of animal model, duration, and type of IRI and reporting of histological findings. Increased macrovesicular steatosis (>30%) was associated with increased histological damage, liver function derangement, and reduced survival. Increased duration of warm or cold ischemia had a negative impact on all outcomes measured. Microvesicular steatosis did not influence outcome. Conclusions. Findings from this systemic review support the hypothesis that livers with >30% macrovesicular steatosis are less tolerant of IRI. Clinically, it is likely that these findings are applicable to patients undergoing hepatic resection, but further studies are required to confirm these data.