[The protective effect and mechanism of ischemic preconditioning for hepatic resection under hepatic blood inflow occlusion in hepatocellular carcinoma patients with cirrhosis].
OBJECTIVE
To investigate the protective effect of ischemic preconditioning (IPC) for hepatic resection under hepatic blood inflow occlusion (HBIO) in hepatocellular carcinoma patients with cirrhosis and its possible mechanism.


METHODS
29 consecutive patients resectable HCC were randomized into two groups. IPC group: before HBIO, IPC with 5 min of ischemia and 5 min of reperfusion was given; control group: simple HBIO. The liver function, hepatic caspase-3 activity, and apoptotic cell were compared between the two groups.


RESULTS
The AST, ALT levels of POD 1, POD 3 and POD 7 in the IPC group were significantly higher than those of the control group, respectively (t = 4.238, P < 0.05). The TBIL levels of POD 3 and POD 7 in the IPC group were significantly higher than those of the control group, respectively (t = 2.296, P < 0.05). The ALB of POD 1 in the IPC group was higher than in the control group (t = 2.029, P > 0.05). After 1 h of reperfusion, the hepatic caspase-3 activity and apoptotic sinusoidal endothelial cell were significantly higher than those of in the control group (t = 2.349, P < 0.05).


CONCLUSIONS
IPC has the a protective effect in hepatic resection under HBIO in HCC patients with cirrhosis. Its mechanism is that sinusoidal endothelial cell apoptosis is inhibited by inhibiting caspase-3 activity.
Department of Hepatobiliary Surgery, First Affiliated Hospital, Sun Yet-sen University of Medical Sciences, Guangzhou 510080, China.
Lijian
L
Liang
Shaoqiang
S
Li
Jiefu
J
Huang
D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D053148:Caspase 3; D020169:Caspases / Q000378:metabolism; D005260:Female; D006801:Humans; D019194:Ischemic Preconditioning; D008103:Liver Cirrhosis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged
C505407:CASP3 protein, human; D053148:Caspase 3; D020169:Caspases