title: The influence of preconditioning on metabolic changes in the pig liver before, during, and after warm liver ischemia measured by microdialysis.
abstract: OBJECTIVE
  Ischemia-reperfusion injury induced by the Pringle maneuver is a well-known problem after liver surgery. The aim of this study was to monitor metabolic changes in the pig liver during warm ischemia and the following reperfusion preceded by ischemic preconditioning (IPC).
  
  
  METHODS
  Eight Landrace pigs underwent laparotomy. Two microdialysis catheters were inserted in the liver, one in the left lobe and another in the right lobe. A reference catheter was inserted in the right biceps femoris muscle. Microdialysis samples were collected every 30 min during the study. After 2 h of baseline measurement, IPC was performed by subjecting pigs to 10 min of ischemia, followed by 10 min of reperfusion. Total ischemia for 60 min was followed by 3 h of reperfusion. The samples were analyzed for glucose, lactate, pyruvate, and glycerol. Blood samples were drawn three times to determine standard liver parameters.
  
  
  RESULTS
  All parameters remained stable during baseline. Glycerol and glucose levels increased significantly during ischemia, followed by a decrease from the start of reperfusion. During the ischemic period, lactate levels increased significantly and decreased during reperfusion. The lactate-pyruvate ratio increased significantly during ischemia and decreased rapidly during reperfusion. Only minor changes were observed in standard liver parameters.
  
  
  CONCLUSIONS
  The present study demonstrated profound metabolic changes before, during, and after warm liver ischemia under the influence of IPC. Compared with a similar study without IPC, the metabolic changes seem to be unaffected by preconditioning.
authors: Department of Surgical Gastroenterology L, Aarhus University Hospital, 8000, Aarhus C, Denmark, askannerup@gmail.com.
authors: Anne-Sofie
authors: AS
authors: Kannerup
authors: Henning
authors: H
authors: Grønbæk
authors: Peter
authors: P
authors: Funch-Jensen
authors: Rasmus Langelund
authors: RL
authors: Jørgensen
authors: Frank Viborg
authors: FV
authors: Mortensen