Preconditioning, organ preservation, and postconditioning to prevent ischemia-reperfusion injury to the liver

Abstract

and reperfusion lead to injury of the liver. Ischemia-reperfusion injury is inevitable in liver transplantation and trauma and, to a great extent, in liver resection. This article gives an overview of the mechanisms involved in this type of injury and summarizes protective and treatment strategies in clinical use today. Intervention is possible at different time points: during harvesting, during the period of preservation, and during implantation. Liver preconditioning and postconditioning can be applied in the transplant setting and for liver resection. Graft optimization is merely possible in the period between the harvest and the implantation. Given that there are 3 stages in which a surgeon can intervene against ischemia-reperfusion injury, we have structured the review as follows. The first section reviews the approaches using surgical interventions, such as ischemic preconditioning, as well as pharmacological applications. In the second section, static organ preservation and machine perfusion are addressed. Finally, the possibility of treating the recipient or postconditioning is discussed.

Comparison of skin perfusion response with alternating and constant pressures in people with spinal cord injury

“…The method of determining whether ischemia reperfusion injury occurs is by assessing the free radicals level, although the specific mechanism remains to be studied. 27 In general, the time of ischemia needed to induce ischemia reperfusion injury is much longer than the Skin perfusion response to alternating pressure in SCI Y-K Jan et al alternating pressure cycle (5 min) tested in this study. 28 Our protocol is more similar to the preconditioning ischemia protocol, which is used to minimize the damage associated with ischemia reperfusion injury.…”

Protective effects ofHammada scopariaflavonoid-enriched fraction on liver injury induced by warm ischemia/reperfusion

“…Hepatic ischemia/reperfusion injury (IRI) is a one of the major complications in clinical hepatic surgeries, including liver transplantation and hepatic resection procedures (DeRougemont et al, 2009;Jaeschke, 2003a). Ischemia/ reperfusion injury is a major cause of liver damage, which can be mediated by diverse and complex cellular and biochemical processes, such as the deregulation of the healthy phenotype of all liver cellular components (Peralta et al, 2013).…”

“…Among these, the ischemic preconditioning (DeRougemont et al, 2009;Peralta et al, 2003;Zhang et al, 2009) and ischemic postconditioning of the liver by intermittent interruptions of blood flow in the early phase of reperfusion have been reported to improve post-transplant liver function in rat models (Wang et al, 2008;Zhang et al, 2009) and to induce tissue-protective effects after ischemia and reperfusion injury.…”

The Role of Hypoxia-Induced Factor-1 (Hif-1) in Cytoprotection Effect in Ischemic and Pharmacologic Postconditioning

“…Протек-тивный эффект ИПостК реализуется за счет выпол-нения коротких ишемических эпизодов, выполненных в реперфузионном периоде после продолжительной ишемии [1][2][3][4]. Впервые цитопротективный эффект ИПостК был обнаружен в экспериментальных иссле-дованиях на сердце.…”

“…Было установлено, что 3 эпизода ишемии по 30 секунд, разделенные 30-секундными эпизодами реперфузии, при выполнении непосред-ственно после 60-минутной ишемии позволяют уменьшить степень необратимого повреждения мио-карда [4]. Позднее протективный эффект ИПостК был описан и при воспроизведении ишемии-репер-фузии других органов, включая головной и спинной мозг, печень, почку, легкое, тонкую кишку [1, 3,[5][6][7]. При дальнейшем изучении феномена ИПостК было показано, что цитопротективным действием обла-дают ишемические стимулы различной кратности и длительности, выполненные в разные сроки после прекращения тестовой (пролонгированной) ишемии.…”