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

Scientific paper - Original scientific paper

• Author: Mislav Rakić
• Author: Leonardo Patrlj
• Author: Fedor Amić
• Author: Gorana Aralica
• Author: Ivica Grgurević
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

AIM:
To compare and evaluate the hepatoprotective effect of remote ischemic preconditioning (RIPC) with local ischemic preconditioning (LIPC) of the liver during human liver resections. ----- METHODS:
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****). ----- RESULTS:
Significant differences were found in serum levels of liver transaminases and bilirubin levels between the groups, 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. ----- CONCLUSION:
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.

• Keywords (english): Aged; Bilirubin/blood; Cholinesterases/blood; Colorectal Neoplasms/pathology; Colorectal Neoplasms/surgery; Female; Hepatectomy/adverse effects; Hepatectomy/methods; Humans; Ischemic Preconditioning/methods; Liver/blood supply; Liver/pathology; Liver Neoplasms/blood; Liver Neoplasms/secondary; Liver Neoplasms/surgery; Male; Middle Aged; Prospective Studies; Reperfusion Injury/etiology; Reperfusion Injury/prevention & control; Serum Albumin/analysis; Transaminases/blood
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Accepted version
• Journal title: International Journal of Surgery
• Numbering: vol. 54, no. Pt A, pp. 248-253
• p-ISSN: 1743-9191
• DOI: https://doi.org/doi:10.1016/j.ijsu.2018.05.001
• URN:NBN: urn:nbn:hr:105:565127
• Publication: 2018-06
• Document URL: http://doi.org/10.1016/j.ijsu.2018.05.001
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 10:18:10