Unilateral ischemic preconditioning and heterologous preconditioning in living donor liver transplantation

Testa, Giuliano; Angelova, Victoria; Laricchia-Robbio, Leopoldo; Rondelli, Damiano; Chejfec, Gregorio; Anthony, Tiffany; Benedetti, Enrico

doi:10.1111/j.1399-0012.2009.01075.x

Cited by 11 publications

(7 citation statements)

References 20 publications

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“…This single centre prospective study involving 44 consecutive cases of elective adult‐to‐adult living related right lobe liver transplantation is one of the few studies 37,38 to evaluate the potential benefit of ischaemic preconditioning of the graft in this model.…”

Section: Discussionmentioning

confidence: 99%

Ischaemic preconditioning of the graft in adult living related right lobe liver transplantation: impact on ischaemia–reperfusion injury and clinical relevance

Andreani¹,

Hoti²,

Serna³

et al. 2010

HPB

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Section: Discussionmentioning

confidence: 99%

Ischaemic preconditioning of the graft in adult living related right lobe liver transplantation: impact on ischaemia–reperfusion injury and clinical relevance

Andreani¹,

Hoti²,

Serna³

et al. 2010

HPB

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“…Moreover, the posttransplant AST levels, prothrombin times, and bilirubin levels were lower in the group that received ischemic preconditioning. In contrast, Testa et al 35 reported that ischemic preconditioning failed to have any impact on either clinical outcomes or the laboratory values in living donor LT. Moreover, a recent article reported an interesting result termed the ischemic preconditioning paradox, in which ischemic preconditioning increased the incidence of IRI after deceased donor LT and resulted in an increase in AST and ALT levels in the early posttransplant period.…”

Section: Discussionmentioning

confidence: 93%

Effect of remote ischemic postconditioning on patients undergoing living donor liver transplantation

Lee

Min

et al. 2014

Liver Transpl

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The aim of this study was to evaluate the protective effect of remote ischemic postconditioning (RIPostC) on graft function and acute kidney injury (AKI) after living donor liver transplantation (LT). Recipients undergoing elective living donor LT were randomly assigned to either the RIPostC group or the control group. Immediately after reperfusion, 4 cycles of ischemia and reperfusion lasting for 5 minutes each were performed on 1 upper limb in the RIPostC group. Graft function was assessed through evaluations of the serum levels of total bilirubin and liver enzymes and the prothrombin time for 28 days after surgery. The incidence of AKI, as defined by the Risk, Injury, Failure, Loss, and End-Stage Kidney Disease classification, was evaluated within 28 days of the operation. In addition, the incidences of graft dysfunction, acute cellular rejection, and major complications; the 1-, 3-, and 6-month mortality rates; the length of stay in the intensive care unit; and the length of hospital stay were also investigated. In all, 78 patients were enrolled in the analysis (n 5 39 in each group). No differences in graft function or clinical outcomes were observed between the groups. The incidences of postoperative AKI were 38% (n 5 15) in the RIPostC group and 72% (n 5 28) in the control group (P 5 0.006). Despite no improvements in postoperative graft function, RIPostC decreased the incidence of postoperative AKI after living donor LT in this study. However, no other clinical benefits with respect to the complication rate, length of hospital stay, or short-term mortality rate were observed. Thus, further studies will be needed to evaluate the clinical efficacy of RIPostC in LT fully.

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“…Histological assessment of IRI was based on presence of >10% hepatocyte necrosis. Based on these two studies, there was no difference in all outcome measures between recipients of IPC and nonpreconditioned liver grafts [ 33 , 34 ].…”

Section: Resultsmentioning

confidence: 99%

“…There have been only two studies of IPC in LRLT published in the literature thus far [ 33 , 34 ]. There is a need to consider the unique setting of LRLT with short ischemic time and healthier donors who have no underlying liver disease compared to cadaveric liver transplantation.…”

Section: Discussionmentioning

confidence: 99%

Impact of Ischemic Preconditioning on Outcome in Clinical Liver Surgery: A Systematic Review

Chu

Vather

Hickey

et al. 2015

BioMed Research International

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Background. Ischemia-reperfusion injury is a major cause of post-liver-surgery complications. Ischemic preconditioning (IPC) has been demonstrated to protect against ischemia-reperfusion injury. Clinical studies have examined IPC in liver surgery but with conflicting results. This systematic review aimed to evaluate the effects of IPC on outcome in clinical liver surgery. Methods. An electronic search of OVID Medline and Embase databases was performed to identify studies that reported outcomes in patients undergoing liver surgery subjected to IPC. Basic descriptive statistics were used to summarise data from individual clinical studies. Results. 1093 articles were identified, of which 24 met the inclusion criteria. Seven topics were selected and analysed by subgroup. There were 10 studies in cadaveric liver transplantation, 2 in living-related liver transplantation, and 12 in liver resection. IPC decreases hepatocellular damage in liver surgery as determined by transaminases but does not translate to any significant clinical benefit in orthotopic liver transplant or liver resection. Conclusions. Available clinical evidence does not support routine use of IPC in liver surgery as it does not offer any apparent benefit in perioperative outcome. Further clinical studies will need to be carried out to determine the subset of patients that will benefit from IPC.

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Unilateral ischemic preconditioning and heterologous preconditioning in living donor liver transplantation

Cited by 11 publications

References 20 publications

Ischaemic preconditioning of the graft in adult living related right lobe liver transplantation: impact on ischaemia–reperfusion injury and clinical relevance

Ischaemic preconditioning of the graft in adult living related right lobe liver transplantation: impact on ischaemia–reperfusion injury and clinical relevance

Effect of remote ischemic postconditioning on patients undergoing living donor liver transplantation

Impact of Ischemic Preconditioning on Outcome in Clinical Liver Surgery: A Systematic Review

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