Although the liver is the only organ with regenerative capacity, various injury factors induce irreversible liver dysfunction and end‐stage liver disease. Liver resection and liver transplantation (LT) are effective treatments for individuals with liver failure, liver cirrhosis and liver cancers. The remnant or transplanted liver tissues will undergo hepatic ischaemia/reperfusion (IR), which leads to oxidative stress, inflammation, immune injury and liver damage. Moreover, systemic ischaemia induced by trauma, stroke, myocardial ischaemia, haemorrhagic shock and other injury factors also induces liver ischaemia/reperfusion injury (IRI) in individuals. Hepatic IRI can be divided into warm IRI, which is induced by liver surgery and systemic ischaemia, and cold IRI, which is induced by LT. Multiple studies have shown that melatonin (MT) acts as an endogenous free radical scavenger with antioxidant capacity and is also able to attenuate hepatic IRI via its anti‐inflammatory and antiapoptotic capacities. In this review, we discuss the potential mechanisms and current strategies of MT administration in liver surgery for protecting against warm or cold hepatic IRI. We highlight strategies to improve the efficacy and safety of MT for attenuating hepatic IRI in different conditions. After the potential mechanisms underlying the interactions between MT and other important cellular processes during hepatic IR are clarified, more opportunities will be available to use MT to treat liver diseases in the future.

中文翻译：

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褪黑素及其在减轻冷热肝脏缺血/再灌注损伤中的保护作用

尽管肝脏是唯一具有再生能力的器官，但各种损伤因素会诱发不可逆的肝功能障碍和终末期肝病。肝切除和肝移植（LT）是对肝功能衰竭，肝硬化和肝癌患者的有效治疗方法。残留或移植的肝组织将经历肝缺血/再灌注（IR），这会导致氧化应激，炎症，免疫损伤和肝损害。此外，由外伤，中风，心肌缺血，出血性休克和其他损伤因素引起的全身性缺血也可引起个体的肝缺血/再灌注损伤（IRI）。肝IRI可以分为由肝脏手术和全身缺血引起的温暖IRI和由LT引起的寒冷IRI。多项研究表明，褪黑激素（MT）可作为具有抗氧化能力的内源性自由基清除剂，并且还能够通过其抗炎和抗凋亡能力来减轻肝脏IRI。在这篇综述中，我们讨论了肝手术中MT预防热或冷肝IRI的潜在机制和当前策略。我们重点介绍了在不同条件下改善MT减弱肝脏IRI疗效和安全性的策略。在阐明了MT与肝IR过程中其他重要细胞过程之间相互作用的潜在机制后，将来将有更多机会使用MT治疗肝病。