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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

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Title: 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
Authors: Mislav Rakić, Leonardo Patrlj, Fedor Amić, Gorana Aralica, Ivica Grgurević
Source: International Journal of Surgery. 54:248-253
Publisher Information: Ovid Technologies (Wolters Kluwer Health), 2018.
Publication Year: 2018
Subject Terms: Male, Bilirubin/blood, Hepatectomy/adverse effects, Liver Neoplasms/surgery, 03 medical and health sciences, Liver/blood supply, 0302 clinical medicine, Transaminases/blood, Reperfusion Injury/prevention & control, Cholinesterases, Hepatectomy, Humans, Reperfusion Injury/etiology, Prospective Studies, Ischemic Preconditioning/methods, Ischemic Preconditioning, Serum Albumin/analysis, Serum Albumin, Transaminases, Aged, Colorectal Neoplasms/pathology, Liver Neoplasms/blood, Liver Neoplasms, Bilirubin, Middle Aged, Colorectal Neoplasms/surgery, 3. Good health, Liver, Liver Neoplasms/secondary, Reperfusion Injury, Female, Liver/pathology, Cholinesterases/blood, Hepatectomy/methods, Colorectal Neoplasms
Description: To compare and evaluate the hepatoprotective effect of remote ischemic preconditioning (RIPC) with local ischemic preconditioning (LIPC) of the liver during human liver resections.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****).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.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.
Document Type: Article
File Description: application/pdf
Language: English
ISSN: 1743-9191
DOI: 10.1016/j.ijsu.2018.05.001
Access URL: https://pubmed.ncbi.nlm.nih.gov/29733995
https://pubmed.ncbi.nlm.nih.gov/29733995/
https://www.ncbi.nlm.nih.gov/pubmed/29733995
https://www.sciencedirect.com/science/article/pii/S1743919118307465
https://urn.nsk.hr/urn:nbn:hr:105:565127
https://doi.org/doi:10.1016/j.ijsu.2018.05.001
http://doi.org/10.1016/j.ijsu.2018.05.001
Rights: Elsevier Non-Commercial
URL: http://rightsstatements.org/vocab/InC/1.0/
Accession Number: edsair.doi.dedup.....5a4c778001c272be891e2e749ea9160e
Database: OpenAIRE
Description
Abstract:To compare and evaluate the hepatoprotective effect of remote ischemic preconditioning (RIPC) with local ischemic preconditioning (LIPC) of the liver during human liver resections.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****).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.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.
ISSN:17439191
DOI:10.1016/j.ijsu.2018.05.001