Page 51 - CASA Bulletin of Anesthesiology 2022; 9(3)-1 (1)

Vol. 9, No 3, 2022

highlighted the notion of multi-organ cross-talk and the difficulty in tackling MOD in the
intensive care units .
9
Accumulating studies have demonstrated that necroptosis is a key cell death mechanism
underlying ischaemia-reperfusion organ injury 10-11 and chronic inflammatory disease 12-14 .
Necroptosis also plays a central role in remote, multiple organ injury, as our group showed that
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necroptosis underlies lung injury that develops secondary to renal transplantation . The salient
observation that inhibition of necroptosis prevents sterile (non-pathogen induced) inflammation
suggests necroptosis as a form of inflammatory, immunogenic cell death, and highlights the
therapeutic potential of targeting necroptosis in the prevention and treatment of multiple organ
dysfunction and inflammation 16-18 . The precise molecular mechanisms linking necroptosis to
sterile inflammation remain uncertain and elucidating such molecular interactions in the context
of postoperative MOD will open up novel avenues for postoperative patient management.
Therefore, further mechanistic studies will be needed to identify potential therapeutic targets for
the prevention and treatment of postoperative MOD/MOF. However, at the present, clinicians
are strongly advised to carefully assess patients’ conditions including their neurologic functional
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status before surgery , to take any necessary measures to protect organ vital functions and to
ensure vulnerable or frail patients can recover from traumatic surgery.

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