The role of the neutrophil in ischaemia-reperfusion injury: potential therapeutic interventions

The pathogenesis of the reperfusion syndrome is complex and as yet not fully elucidated. It is characterized by the development of increased microvascular permeability, oedema and tissue necrosis, and is associated with free radical release, cellular calcium overload and activation of neutrophils, Furthermore, systemic release of putative mediators may result in distant organ injury (lung, kidney, heart). This review, after briefly describing the role of neutrophils in these events, will concentrate on potential therapeutic interventions that might be employed to minimise ischaemia-reperfusion syndrome. Issues of safety will be considered, and potential applications of these techniques in patient management discussed. (C) 1998 The International Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights reserved.