Comparison of hepatoprotective effect from ischemia-reperfusion injury of remote ischemic preconditioning of the liver vs local ischemic preconditioning of the liver during human liver resections

被引:25
作者
Rakic, Mislav [1 ]
Patrlj, Leonardo [1 ]
Amic, Fedor [1 ]
Aralica, Gorana [2 ]
Grgurevic, Ivica [3 ]
机构
[1] Univ Hosp Dubrava, Dept Hepatobiliary Surg, Ave Gojka Suska 6, Zagreb 10000, Croatia
[2] Univ Hosp Dubrava, Dept Pathol, Zagreb, Croatia
[3] Univ Hosp Dubrava, Dept Gastroenterol, Zagreb, Croatia
关键词
Ischemia-reperfusion injury; Remote ischemic preconditioning; Liver resection; Liver metastasis; INFLOW OCCLUSION; WARM ISCHEMIA; TRANSPLANTATION; PROTOCOLS; MODEL; RATS; METASTASIS; MODULATION; PROTECTION; APOPTOSIS;
D O I
10.1016/j.ijsu.2018.05.001
中图分类号
R61 [外科手术学];
学科分类号
摘要
Aim: To compare and evaluate the hepatoprotective effect of remote ischemic preconditioning (RIPC) with local ischemic preconditioning (LIPC) of the liver during human liver resections. Methods: A prospective, single-centre, randomised control trial was conducted in the Clinical Hospital "***" from April 2017 to January 2018. A total of 60 patients, who underwent liver resection due to colorectal cancer liver metastasis, were randomised to one of three study arms: 1) a RIPC group, 2) an LIPC group and 3) a control group (CG) in which no ischemic preconditioning was done before liver resection. The hepatoprotective effect was evaluated by comparing serum transaminase levels, bilirubin levels, albumin, and protein levels, coagulograms and through pathohistological analysis. The trial was registered on ClinicalTrials.gov (NCT****). Results: Significant differences were found in serum levels of liver transaminases and bilirubin levels between thegroups, the highest level in the CG and the lowest level in the LIPC group. Levels of cholinesterase were also significantly higher in the LIPC group. Pathohistological findings graded by the Rodriguez score showed favourable changes in the LIPC and RIPC groups versus the CG. Conclusion: Strong evidence supports the hepatoprotective effect of RIPC and LIPC preconditioning from an ischemia-reperfusion injury of the liver. Better synthetic liver function preservation in these two groups supports this conclusion.
引用
收藏
页码:248 / 253
页数:6
相关论文
共 39 条
  • [31] Experimental orthotopic lung transplantation model in rats with cold storage
    Sugimoto, Ryujiro
    Nakao, Atsunori
    Nagahiro, Itaru
    Kohmoto, Junichi
    Sugimoto, Seiichiro
    Okazaki, Mikio
    Yamane, Masaomi
    Inokawa, Hidetoshi
    Oto, Takahiro
    Tahara, Kazunori
    Zhan, Jianghua
    Sano, Yoshifumi
    McCurry, Kenneth R.
    [J]. SURGERY TODAY, 2009, 39 (07) : 641 - 645
  • [32] Remote ischemic perconditioning-a simple, low-risk method to decrease ischemic reperfusion injury: Models, protocols and mechanistic background. A review
    Szijarto, Attila
    Czigany, Zoltan
    Turoczi, Zsolt
    Harsanyi, Laszlo
    [J]. JOURNAL OF SURGICAL RESEARCH, 2012, 178 (02) : 797 - 806
  • [33] Haemoxygenase modulates cytokine induced neutrophil chemoattractant in hepatic ischemia reperfusion injury
    Tapuria, Niteen
    Junnarkar, Sameer
    Abu-amara, Mahmoud
    Fuller, Barry
    Seifalian, Alexander M.
    Davidson, Brian R.
    [J]. WORLD JOURNAL OF GASTROENTEROLOGY, 2016, 22 (33) : 7518 - 7535
  • [34] Modulation of microcirculatory changes in the late phase of hepatic ischaemia-reperfusion injury by remote ischaemic preconditioning
    Tapuria, Niteen
    Junnarkar, Sameer
    Abu-Amara, Mahmoud
    Fuller, Barry
    Seifalian, Alexander M.
    Davidson, Brian R.
    [J]. HPB, 2012, 14 (02) : 87 - 97
  • [35] Effect of remote ischemic preconditioning on hepatic microcirculation and function in a rat model of hepatic ischemia reperfusion injury
    Tapuria, Niteen
    Junnarkar, Sameer P.
    Dutt, Neelanjana
    Abu-Amara, Mahmoud
    Fuller, Barry
    Seifalian, Alexander M.
    Davidson, Brian R.
    [J]. HPB, 2009, 11 (02) : 108 - 117
  • [36] Remote ischemic preconditioning promotes early liver cell proliferation in a rat model of small-for-size liver transplantation
    Wang, Meng
    Shen, Jian
    Feng, Bing
    Gui, Liang
    Chen, Qi
    Zhang, Bin
    Tang, Jincao
    Li, Xiangcheng
    [J]. JOURNAL OF SURGICAL RESEARCH, 2013, 179 (01) : E245 - E253
  • [37] Delayed ischemic preconditioning contributes to renal protection by upregulation of miR-21
    Xu, Xialian
    Kriegel, Alison J.
    Liu, Yong
    Usa, Kristie
    Mladinov, Domagoj
    Liu, Hong
    Fang, Yi
    Ding, Xiaoqiang
    Liang, Mingyu
    [J]. KIDNEY INTERNATIONAL, 2012, 82 (11) : 1167 - 1175
  • [38] Ischemic preconditioning protects the mouse liver by inhibition of apoptosis through a caspase-dependent pathway
    Yadav, SS
    Sindram, D
    Perry, DK
    Clavien, PA
    [J]. HEPATOLOGY, 1999, 30 (05) : 1223 - 1231
  • [39] [No title captured]