Ischemic preconditioning and intermittent clamping increase the tolerance of fatty liver to hepatic ischemia-reperfusion injury in the rat.
BACKGROUND
Liver ischemia-reperfusion (I/R) injury is a well-known cause of morbidity and mortality following liver surgery and transplantation. Hepatic steatosis increases the extent of cellular injury incurred during I/R injury. We sought to identify measures that reduced the untoward sequelae of liver I/R injury.


METHODS
Male Zucker rats were subjected to 75 minutes of 70% hepatic ischemia, and 3 hours of reperfusion. The ischemic periods were based on the following protocols: continuous clamping (CC) for 75 minutes; intermittent clamping (IC) with five cycles of 15 minutes clamp on and 5 minutes clamp off; or ischemic preconditioning (IP) with 10 minutes clamp on, 15 minutes off, and 60 minutes on (n=7 in each group). Warm I/R injury was evaluated using serum levels of aspartate aminotransferase (AST), serum interleukin (IL)-6, as well as hematoxylin and eosin staining.


RESULTS
Hepatocellular injury was significantly reduced with IP or IC compared with CC (AST: 3285+/-122.3 and 2875+/-285.4 compared with 5436.3+/--984.7 units/L, respectively; P<.01). Serum IL-6 level was also significantly reduced with IP and IC compared with CC (70+/-8.8 and 76+/-6.2 compared with 147+/-8.5 ng/l, respectively (p<.01). Histological analysis also revealed that IC and IP provided significant protection compared with the CC group.


CONCLUSIONS
IC and IP increased the tolerance of a fatty liver to hepatic I/R injury.
Saidi
R F
RF
Department of Surgery, Providence Hospital and Medical Centers, Southfield, Michigan 48075, USA.
Chang
J
J
Brooks
S
S
Nalbantoglu
I
I
Adsay
V
V
Jacobs
M J
MJ
D000768:Anesthesia, General; D000818:Animals; D005234:Fatty Liver / Q000150:complications* / Q000473:pathology; D019194:Ischemic Preconditioning; D008099:Liver / Q000098:blood supply / Q000473:pathology; D008102:Liver Circulation; D008297:Male; D051381:Rats; D011924:Rats, Zucker; D015427:Reperfusion Injury / Q000473:pathology / Q000517:prevention & control*