Background
Fatty livers occur in up to 20% of potential liver donors and show an increase in cellular injury during the ischemia/reperfusion phase, so any intervention that could enable a better outcome of grafts for liver transplantation would be very useful.

Materials and Methods
Forty fa/fa Zucker rats were divided in 4 groups. 3 groups were subjected to 35 min of warm hepatic ischemia and 36 h of reperfusion. One experimental group remained untreated and two were given 10 mg/kg melatonin intraperitoneally or orally. Another group was sham-operated. Plasma and hepatic metabolites were determined. The levels of cytokines were analysed in liver by ELISA. The expression of genes were determined by RT-PCR.

Results
Hepatoprotective effects against warm I/R injury were clearly demonstrated by normalizing the TG content in the liver, ALT, AST levels and by decreasing the amount of coagulation necrosis after melatonin administration. Melatonin helped improving the ability of the steatotic hepatocyte to produce ATP. Oral administration of melatonin decreased gene expressions and tissue levels of TNF-x and IL1-B and significantly enhanced the level of IL10. mRNA expression of NFkB1/2, PCNA, SERB 1c, ACAC were increased during I/R and melatonin diminished mRNA of all these parameters.

conclusion
We conclude that melatonin improved liver function, as well as markers of pro/antioxidant status and apoptosis following ischemia/reperfusion in obese rats with fatty liver. These data suggest that this substance could improve outcome in patients undergoing liver transplantation who receive a fatty liver implant and suggest the need of clinical trials with it in liver transplantation.