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ISCHAEMIC PRECONDITIONING OF THE LIVER: A PRELIMINARY STUDY
Author(s) -
Hardy Kenneth J.,
McClure David N.,
Subwongcharoen Somboon
Publication year - 1996
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1996.tb00722.x
Subject(s) - medicine , ischemia , reperfusion injury , liver function , anesthesia , bilirubin , ischemic preconditioning , surgery
Background: A phenomenon of ‘preconditioning’ exists for the heart, but has not been described for the liver. This study was undertaken to determine whether a brief episode of ischaemia (3 or 5 min) followed by a short reperfusion time (5 or 10 min) would precondition the liver to reduce subsequent injury from prolonged ischaemia (30 to 90 min). Methods: Male Wistar rats were allocated into five control (no preconditioning) and five preconditioned groups, each having a liver resection. The preconditioning times were 3 rnin ischaemia followed by 5 rnin reperfusion with a prolonged ischaemia of 60 or 90 min for the first two groups, and 5 min ischaemia followed by 10 rnin reperfusion with prolonged ischaemia times of 30 or 45 min for the other three groups. Results: Of rats resected with 3–5–60 rnin time sequence designed to assess survival, 9/10 died. However 9/10 died also in the matching control group with 60 rnin ischaemia. With a 5–10–45 rnin sequence, 9/10 survived more than 24 h in the preconditioned group and 1/10 in the non‐preconditioned controls. With a 5–10–30+ sequence designed to measure liver function tests, the prothrombin time was significantly improved; bilirubin, serum alkaline phosphatase and the alanine aminotransferase improved but these did not reach significance. Conclusion: A brief episode of ischaemia followed by an episode of reperfusion before a prolonged period of ischaemia ameliorated the effects of ischaemia‐reperfusion injury in a rat liver resection model. If hepatic preconditioning is confirmed in humans, ischaemic preconditioning will have an important role for all liver surgery.