Comparison of the Effects of the Remote and Direct Ischemic Preconditioning in the Liver Ischemia-Reperfusion Injury

Objective: Ischemia reperfusion (IR) injury can cause severe organ failures. Remote and direct ischemic preconditioning can be used to prevent ischemia-reperfusion injury. Present study compares the effects of remote and direct ischemic preconditioning in the rat model of hepatic ischemia-reperfusion injury. Material and Methods: Four groups, each including seven rats were included. In the sham group only laparotomy was performed. In the ischemia reperfusion group 25 minutes of total hepatic ischemia was induced followed by 120 minutes of reperfusion. The leg was subjected to three cycles of ischemic preconditioning (IP) before hepatic ischemia reperfusion in the remote IP + IR group. One cycle of hepatic ischemic preconditioning was performed before hepatic ischemia reperfusion in the direct IP+IR group. The length of the experiment was the same in all groups. At the end of the experiment blood and Liver samples were collected. Results: Levels of serum aspartate transaminase (AST) and alanine transaminase (ALT) were significantly lower in the sham group compared to other groups (p<0.001). Levels of serum AST and ALT in the remote IP + IR group were significantly lower than in the direct IP + IR (p<0.001, p<0.001, respectively) and IR groups (p<0.001, p=0.002, respectively). Hepatic tissue malondialdehid level and the histological score of liver injury were significantly lower than in the direct IP + IR group (p<0.001, p=0.002, respectively). Conclusion: Present study showed that when serum AST-ALT levels and hepatic histological score are considered, remote ischemic preconditioning protects the liver from ischemia reperfusion injury better than direct ischemic preconditioning. The effects and mechanisms of these two preconditioning methods must be compared in clinical and experimental studies.