Hepatic
ischemia-reperfusion syndrome has been the subject of intensive study and experimentation in recent decades since it is responsible for the outcome of several clinical entities, such as major hepatic resections and
liver transplantation. In addition to the organ's post
reperfusion injury, this syndrome appears to play a central role in the dysfunction of distant tissues and systems. Thus, continuous research should be directed toward finding effective therapeutic options to improve the outcome and reduce the postoperative morbidity and mortality rates.
Treprostinil is a synthetic analog of
prostaglandin I2, and its experimental administration has shown encouraging results. It has already been approved by the Food and Drug Administration in the United States for
pulmonary arterial hypertension and has been used in
liver transplantation, where preliminary encouraging results showed its safety and feasibility by using continuous
intravenous administration at a dose of 5 ng/kg/min.
Treprostinil improves renal and hepatic function, diminishes hepatic oxidative stress and lipid peroxidation, reduces hepatictoll-like receptor 9 and
inflammation, inhibits hepatic apoptosis and restores hepatic
adenosine triphosphate (
ATP) levels and
ATP synthases, which is necessary for functional maintenance of mitochondria.
Treprostinil exhibits vasodilatory properties and antiplatelet activity and regulates proinflammatory
cytokines; therefore, it can potentially minimize
ischemia-reperfusion injury. Additionally, it may have beneficial effects on cardiovascular parameters, and much current research interest is concentrated on this compound.