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Functional and structural changes that follow IR tissue injury are mediated by neutrophils through the production of oxygen\u2010derived free radicals, as well as from degranulation which entails the release of proteases and other pro\u2010inflammatory mediators. Neutrophil serine proteases (NSPs) are believed to be the principal triggers of post\u2010ischemic reperfusion damage. Extended preservation times for the transplanted donor organ correlate with heightened occurrences of vascular damage and graft dysfunction. Preservation with \u03b11\u2010antitrypsin, an endogenous inhibitor of NSPs, improves primary graft function after lung or heart transplantation. Furthermore, pre\u2010operative pharmacological targeting of NSP activation in the recipient using chemical inhibitors suppresses neutrophilic inflammation in transplanted organs. Hence, effective control of NSPs in the graft and recipient is a promising strategy to prevent IR injury. In this review, we describe the pathological functions of NSPs in IR injury and discuss their pharmacological inhibition to prevent primary graft dysfunction in lung or heart transplantation.<\/jats:p>","DOI":"10.1111\/febs.17411","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T06:16:37Z","timestamp":1737699397000},"page":"5877-5887","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Protective effects of neutrophil serine protease inhibition against ischemia\u2013reperfusion injury in lung or heart transplantation"],"prefix":"10.1111","volume":"292","author":[{"given":"Sevil","family":"Korkmaz\u2010Ic\u00f6z","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery University Hospital Heidelberg  Germany"},{"name":"Department of Cardiac Surgery University Hospital Halle (Saale)  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