Prevention of hepatic ischemi-reperfusion injury with remote ischemic preconditioning and direct ischemic preconditioning

SUMMARYPrevention of hepatic ischemi-reperfusion injury with remote ischemic preconditioningand direct ischemic preconditioningDr. Elvan Şahin, Dokuz Eylül University, Faculty of Medicine, Department ofAnesthesiology and Reanimation, İzmirThe ischemia reperfusion (IR) injury that can occur after shock, cardiac arrest, majorhepatic surgeries and transplantation could cause severe organ failures. One of the technicsthat can be used to prevent ischemi-reperfusion injury is ischemic preconditioning. Remoteand direct ischemic preconditioning could be used for this aspect. We could not find a studythat compares remote hepatic ischemic preconditioning with direct ishemic preconditioning.This present study compares the effect of remote and direct ishemic preconditioning in the rathepatic ischemi-reperfusion injury.Four groups, each including seven rats were conducted. In the sham group onlylaparotomy was performed. In the ischemia reperfusion group 25 minutes of total hepaticischemia was induced followed by 120 minutes of reperfusion. The leg was subjected to threecycles of ischemic preconditioning (IP) before hepatic ischemia reperfusion in the remoteIP+IR group. One cycle of hepatic ischemic preconditioning was performed before hepaticischemia reperfusion in the direct IP+IR group. The length of the experiment groups weresame. At the end of the experiment rats were killed, blood and liver samples were collected.Levels of AST-ALT were significantly lower in the sham group when compared withthe other groups, in the remote IP+IR group level of the enzymes were significantly lowercompared with the direct IP+IR and IR groups. In the IR, remote IP+IR and direct IP+IRgroups, malondialdehid levels were increased but there were no difference between thesegroups. The histological score of liver injury was significantly lower in the sham groupcompared with the other groups and it was also significantly lower in the remote IP+IR groupcompared with the direct IP+IR group.This present study has shown that when AST-ALT levels and hepatic histologicalscore is considered, remote ischemic preconditioning decreased the hepatic ischemiareperfusion injury. Remote ischemic preconditioning protected liver from ischemiareperfusion injury better than direct ischemic preconditioning according to the results of thisstudy.