Ischemic preconditioning vs adenosine vs prostaglandin E1 for protection against liver ischemia/reperfusion injury

Abstract

Ischemia/reperfusion injury is still a major cause of morbidity and mortality during liver surgery and transplantation. A variety of surgical and pharmacological therapeutic strategies have been investigated to minimize the effects of ischemia/reperfusion. The aim of our study was to analyze and compare preventive influences of ischemic preconditioning, adenosine and prostaglandin E1 in the experimental model of hepatic ischemia/reperfusion injury. Adult chinchilla rabbits were divided into four groups: 10 rabbits subjected to liver ischemic preconditioning (3-min period of inflow occlusion followed by a 5-min period of reperfusion) followed by 45 min of Pringle maneuver; 10 rabbits subjected to pre-treatment with intraportal injection of adenosine followed by 45 min of Pringle maneuver; 10 rabbits subjected to pre-treatment with intraportal injection of prostaglandin E1 followed by 45 min of Pringle maneuver; and control group of 10 rabbits subjected to 45 min of inflow liver ischemia without any preconditioning. On the second postoperative day, blood samples were obtained and biochemical parameters of liver function were measured and compared. Liver tissue samples were also obtained and histopathological changes were compared. Based on biochemical and histopathological parameters, it was demonstrated that ischemic preconditioning provided the best protection against hepatic ischemia/reperfusion injury. This was probably due to a wider range of mechanisms of action of this method oriented to reduce oxidative stress and inflammation, and restore liver microcirculation and hepatocyte energy compared to the examined pharmacological strategies.

Prostaglandin E1 Preconditioning Attenuates Liver Ischemia Reperfusion Injury in a Rat Model of Extrahepatic Cholestasis

“…It is well known that ALT is localized exclusively from the hepatocellular cytoplasm, while both AST and LDH are liver mitochondrial and cytosolic enzymes [ 16 , 17 ]. These enzymes are common indicators to evaluate the degree of hepatocyte damage [ 18 ]. ALT level was positively correlated with the degree and volume of liver cell necrosis in liver IR injury, and the correlation was more apparent at 24 h after reperfusion [ 19 ].…”

TAK242 suppresses the TLR4 signaling pathway and ameliorates DCD liver IRI in rats

“…A number of clinical approaches are presently being applied to minimize IRI, including ischemia pretreatment (IPC), normothermic mechane perfusion and hypothermic mechane perfusion (14,15). Radojkovic et al (16) revealed that IPC exerts a protective effect on IRI by reducing oxidative stress and inflammation in vivo . Mergental et al (17) reported that normothermic machine perfusion increases organ availability for liver transplantation.…”