Figure 1. Mechanisms of ischemia‐reperfusion injury. Ischemia induces anerobic glycolysis, intracellular acidosis, and ion pump dysfunction.

The subsequent calcium influx combined with prolonged ischemia results in cellular necrosis. On reperfusion and restoration of physiologic pH, reactive oxygen species (ROS) generation and intracellular calcium trigger mitochondrial permeability transition pore (MPTP) opening and induce further intracellular calcium overload, proinflammatory cascades, and apoptosis.