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Hepatic ischemia reperfusion injury: Understanding the little components of the larger picture
Eyad Abdulrazzak, Eric R Kallwitz, Division of Hepatology, Department of Medicine, Loyola University Medical Center, Maywood, IL 60153, United States
Author contributions: Abdulrazzak E conducted the literature review, developed the outline, and drafted the initial manuscript; Kallwitz ER critically revised the outline and manuscript drafts, contributed to the development of the final version, and ensured scientific accuracy. Both authors reviewed and approved the final manuscript.
AI contribution statement: An AI tool (ChatGPT) was used solely for language polishing and grammar review to improve clarity and readability. This tool was not used to generate any portion of the manuscript content, nor did they contribute to the study design, data analysis, interpretation of results, or inferences. All scientific content, analyses, and conclusions were developed independently by the authors.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Eric R Kallwitz, MD, Associate Professor, Division of Hepatology, Department of Medicine, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153, United States. ekallwitz@lumc.edu
Received: November 26, 2025
Revised: January 2, 2026
Accepted: April 1, 2026
Published online: August 27, 2026
Processing time: 265 Days and 7.9 Hours
Revised: January 2, 2026
Accepted: April 1, 2026
Published online: August 27, 2026
Processing time: 265 Days and 7.9 Hours
Core Tip
Core Tip: Despite advancements in surgical techniques and preservation, hepatic ischemia-reperfusion injury (H-IRI) remains a critical hurdle in liver transplantation, contributing to early allograft dysfunction. While machine perfusion represents a major macro-level advancement, pharmacological strategies targeting specific molecular pathways remain an important avenue for mitigating H-IRI. This editorial briefly outlines the complexity of H-IRI mechanisms, discusses emerging pharmacological and mechanical interventions, and highlights recent findings on the neurokinin-1 receptor antagonist aprepitant as a potential therapeutic agent.