Current protective strategies in liver surgery

Gurusamy, Kurinchi Selvan; González, Héctor Daniel; Davidson, Brian R

doi:10.3748/wjg.v16.i48.6098

Cited by 41 publications

(35 citation statements)

References 69 publications

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“…Cultured HUVECs were exposed to different temperatures (37,32,28,24,16,12,8 and 4°C) for 10-160 min, during which the pH of the culture medium was monitored and kept constant. Subsequently, cells that detached due to exposure to cold were removed by medium aspiration.…”

Section: Cell Culture and Exposure To Coldmentioning

confidence: 99%

Cold induces reactive oxygen species production and activation of the NF‐kappa B response in endothelial cells and inflammation in vivo

Awad

Khan

Sokolikova

et al. 2013

Journal of Thrombosis and Haemostasis

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Summary. Background: Organs intended for transplantation are generally stored in the cold for better preservation of their function. However, following transplantation and reperfusion, the microvasculature of transplanted organs often proves to be activated. Extensive leukocyte adhesion and microthrombus formation contribute to failure of the transplanted organ. Objectives: In this study we analyzed cold-induced changes to the activation status of cultured endothelial cells, possibly contributing to organ failure. Methods: We exposed human umbilical vein endothelial cells (HUVECs) to temperatures below 37°C (mostly to 8°C) for 30 min and upon rewarming to 37°C kept incubating them for up to 24 h. We also in vivo locally exposed mice to cold. Results: The exposure to low temperatures induced, in HUVECs, expression of the prothrombotic factors plasminogen activator inhibitor-1 (PAI-1) and tissue factor (TF) and of the inflammatory adhesion molecules, E-selectin, intracellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1). Furthermore, upon rewarming for 30 min, we detected activation of the inflammatory NF-jB pathway, as measured by transient NF-jB translocation to the nucleus and IjBa degradation. Using butylated hydroxytoluene (BHT), a scavenger of reactive oxygen species (ROS), we further demonstrated that cold-induced NF-jB activation depends on ROS production. Local exposure to cold also, in vivo, induced ROS production and ICAM-1 expression and resulted in leukocyte infiltration. Conclusions: Our results point to a causative link between ROS production and NF-jB activation, suppression of which had been shown to be beneficial during hypothermic storage and subsequent rewarming of organs for transplantation.

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Section: Cell Culture and Exposure To Coldmentioning

confidence: 99%

Cold induces reactive oxygen species production and activation of the NF‐kappa B response in endothelial cells and inflammation in vivo

Awad

Khan

Sokolikova

et al. 2013

Journal of Thrombosis and Haemostasis

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“…The underlying cause of IRI is complex and involves a multitude of different cell types and signaling mechanisms [3] . Reactive oxygen species and inflammatory mediators, for example, play an important role in IRI [62] . It is not surprising that pharmacological interventions aiming at neutralizing or modulating the pathways of IRI using antioxidants and steroids have been the topic of past and current IRI research [62] .…”

Section: Pharmacological Interventionsmentioning

confidence: 99%

“…In conclusion, there is currently no evidence to suggest a protective effect of IP in patients undergoing liver resection under continues vascular occlusion [5,[60][61][62] . Besides that, the application of IP is not recommended in older patients [63] , since (several cycles of) intermittent ischemia has shown to be more protective [57,64] .…”

Section: Ischemic Preconditioningmentioning

confidence: 99%

Vascular Occlusion or Not during Liver Resection: The Continuing Story

et al. 2012

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Background: Vascular occlusion can be applied during liver resection to reduce blood loss. Herein, we provide an update of the current evidence concerning vascular occlusion. Methods: A systematic literature search was conducted to review the effects of liver in- and outflow occlusion techniques during liver resection, focusing on blood loss and hepatic ischemia-reperfusion injury. Results: The Pringle maneuver (PM) is effective in controlling blood loss; however, there is no indication for routine vascular clamping during hepatic resection in uncomplicated patients. During complex resections and in patients with abnormal liver parenchyma, the intermittent PM is preferred over continuous clamping. Total hepatic vascular exclusion (THVE) is indicated only in resection of tumors involving the inferior caval vein or the caval hepatic junction. THVE can be applied with the preservation of caval vein flow. This mode of selective hepatic vascular exclusion results in less blood loss in combination with the PM. Conclusion: If clamping is necessary during complex resections or in abnormal liver parenchyma, intermittent PM is advised. THVE or selective hepatic vascular exclusion may be considered in tumors involving the inferior caval vein or the caval hepatic junction. There is no evidence supporting the use of ischemic preconditioning, maintenance of a low central venous pressure or of pharmacological interventions during liver resection.

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“…Hipotermi uygulaması, farklı farmakolojik ajanların kullanımı, genetik modülasyon uygulamalarının yanı sıra İÖ ve geç tip önkoşullama bu alanda da umut veren uygulamalardır (57) .…”

Section: Karaciğerunclassified

“…İskemik önkoşullama uygulamasının iskemi-reperfüzyona uğrayan karaciğer üzerinde biyokimyasal ve histolojik görünüm açısından olumlu etkileri kanıt-lanmış olsa da bu olumlu etkilerin klinik yararlarını gösteren randomize kontrollü çalışmalara gereksinim vardır (57) . Bağırsaklar: İskemik önkoşullama uygulaması bağırsaklarda da iskemi-reperfüzyon sonrası doku nekrozunun gelişmesini geciktirerek, bakteriyel translokasyonu azaltarak, intestinal mikrovasküler perfüzyonu ve oksijenizasyonu artırarak olumlu etkilerini göstermiştir (62) .…”

Section: Karaciğerunclassified