Effects of ischemic preconditioning associated to different preservation solutions in protecting the intestinal graft

Abstract

PuRPOsE: To evaluate the effects of ischemic preconditioning (IPC) associate with different preservation solutions, in the protecting of gut. METHOds: Four groups of 14 rats underwent laparotomy and collecting 20 cm of ileum, for preservation, at 4 0 C, in Belzer (Belz), Ringer (RL), Celsior (Cs) and Custodiol (Cust) solutions, for 24 hours. Prior to collection, half of the animals in each group were subjected to IPC. During preservation, in the periods of zero, 12, 18 and 24 hours, were conducted evaluating the degree of mucosal injury and dosage of malondialdehyde acid (MDA). REsuLTs: In all periods the RL group, with and without IPC, presented MDA values higher than the Belz and Cs. The degree of mucosal injury in the non-ipc RLgroup with 12h preservation was higher than the others; with 18 and 24h, the RL and Cust had higher degrees of damage than Cs and Belz. With IPC, in all periods, the group Cs and Belz had lower degrees of injury. CONCLusION: The Celsior and Belzer solutions had better protective effects on the gut and these effects were enhanced by IPC. Keywords: Organ Preservation Solutions. Ischemic Preconditioning. Intestine, Small. Rats. REsuMO OBJETIVO: Avaliar os efeitos do precondicionamento isquêmico (PCI) associado a diferentes soluções de preservação, na proteção do intestino delgado. MéTOdOs: Quatro grupos de 14 ratos Wistar, foram submetidos à laparotomia e coleta de 20 cm de íleo, para preservação, a 4 0 C, nas soluções de Belzer (Belz), Ringer (RL), Celsior (Cs) e Custodiol (Cust) por 24 horas. Previamente à coleta, em metade dos animais de cada grupo, o intestino foi submetido ao PCI. Durante a preservação, nos períodos de Zero, 12, 18 e 24 horas, foram realizados avaliação do grau de lesão da mucosa e dosagem do ácido malondialdeído (MDA). REsuLTAdOs: Em todos os períodos o grupo RL, sem e com pci, apresentou valores maiores de MDA do que o Belz e Cs. O grau de lesão da mucosa nos grupos sem pci com preservação de 12h, no grupo RL, foi maior que nos demais; com 18h e 24h o grupo RL e Cust apresentaram maiores graus de lesão do que Cs e Belz. Com o pci, em todos os períodos, os grupos Belz e Cs apresentaram menores graus de lesão CONCLusãO: As Soluções Celsior e Belzer tiveram melhores efeitos na proteção do intestino e estes efeitos foram incrementados pelo precondicionamento isquêmico. descritores: Soluções para Preservação de Órgãos. Precondicionamento Isquêmico. Intestino Delgado. Ratos.

Different Protocols of Postconditioning Does Not Attenuate Mesenteric Ischemia-Reperfusion Injury After Short-Term Reperfusion

“…Several clinical and experimental studies proved the protective effect of the ischemic preconditioning, as well as, its ability to reduce tissue damage 7 , 15 , 17 . However, in certain clinical settings, it is often difficult to foresee when ischemia will occur, limiting the preconditioning applicability 19 .…”

Ischemic preconditioning modifies mortality and inflammatory response

“…Murry et al 12 , consists of one or multiple short periods of ischemia followed by the same periods of reperfusion, applied prior to prolonged or appropriate ischemia [13][14][15][16] was found to be the most promising strategy to improve intestinal tolerance to I/R injury, and to protect other organs such as lungs, liver, brain, kidneys, pancreas by reducing I/R damage [16][17][18][19] .…”

“…Recently, intestinal transplantation has become the preferred therapy for patients with short bowel syndrome, with intolerance to total parenteral nutrition 14,17,19 . However, the lesion caused by intestinal I/R is a limiting factor for successful intestinal transplantation 19 ,…”

“…and it is as important as the proper preservation of the intestinal graft for minimizing the I/R injury 14,17 .…”

“…Therefore, controlling intestinal I/R injury is important to achieve successful intestinal transplantation 14,17,22 . Among the several strategies developed to minimize the deleterious effects of intestinal I/R, IPC has great importance because it protects the intestine against I/R injury 20 .…”