The effects of remote ischaemic preconditioning and n-acetyl cysteine with remote ischaemic preconditioning in rat hepatic ischaemia reperfusion injury model

Background: Ischaemia reperfusion (IR) injury which can develope after shock, cardiac arrest, major hepatic surgeries, liver transplantation and tourniquet application may result in severe organ failures. Remote ischaemic preconditioning (RIP) and pharmacological preconditioning are the effective methods that can be used to prevent IR injury. The aim of this study was to evaluate the effects of RIP and N-acetyl cysteine (NAC) with RIP in the rat hepatic IR injury model.Materials and Methods: After obtaining approval from the Instutional Ethics Committee, 28 Wistar albino male rats weighing approximately 250-300 g were divided into 4 groups. Laparotomy and hepatic pedicle dissection were performed to all groups under general anaesthesia. Group I (Sham, n=7): Laparotomy and hepatic pedicle dissection were performed but nothing else was done. Group II (IR, n=7): After 30 minutes of hepatic pedicle occlusion, 4 hours of reperfusion was performed. Group III (RIP+IR, n=7): After 3 cycles of ischemic preconditioning applied to left hind leg, hepatic IR was performed.Group IV (RIP+NAC+IR, n=7): After 3 cycles of RIP and intraperitoneal administration of NAC (150 mg/kg), hepatic IR was performed. Durations of anaesthesia were equal in all groups. All the rats were sacrificed after blood samples were taken and liver was Results: The histopathological injury score of liver (HISL) was significantly lower in the sham group compared with the other groups (p< 0.01). The injury score of IR group was significantly higher than the RIP+IR and RIP+NAC+IR groups (p< 0.01). There was no significant difference in HISL between the RIP+IR and RIP+NAC+IR groups. There were no significant differences in biochemical parameters (AST,ALT, LDH) between the IR , RIP+IR and RIP+NAC+IR groups.Conclusions: In the present study, it was demonstrated histopathologically that both RIP and RIP+NAC decreased hepatic IR injury significantly but there was no significant difference between RIP+IR and RIP+NAC+IR groups. According to the biochemical parameters, both methods could not prevent IR injury.Key words: Liver, reperfusion, remote ischaemic preconditioning, N-acetyl cysteine