title: Protective role of heparin in the injury of the liver and kidney on the experimental model of ischemia/reperfusion.
abstract: BACKGROUND
  Surgery of thoracoabdominal aortic aneurysms (TAAA) is associated with high incidence of serious complications. Ischemia/reperfusion (I/R) injury may be responsible for these complications. We investigated the effect of degree of anticoagulation on remote organ I/R injuries and whether heparin is protective against I/R injury in addition to its anticoagulant properties.
  
  
  METHODS
  Spraque Dawley rats were used to determine both liver and kidney concentrations of HSP-70,IL-6, MPO in four groups: ischemic control (operation with cross-clamping and intraperitoneal administration of 0.9% saline, n = 7), sham (operation without cross-clamping, n = 7), heparin (ACT level about 200), and high dose heparin (ACT level up to 600). Histological analyses of the organs were performed.
  
  
  RESULTS
  Histopathological evaluation of kidney presented significant differences between groups with regards to the cytoplasmic vacuole formation, hemorrhage, tubular cell degeneration and tubular dilatation while heparinized group had best results. The kidney MPO and HSP-70 levels significantly decreased (p < 0.05), but IL-6 level was not significant (p > 0.05) in heparinized group when compared to ischemic control group. No statistically significant intergroup differences were detected in the tissue samples of liver. Immunohistochemical markers of the liver were compared and no statistically significant difference was found among the groups.
  
  
  CONCLUSIONS
  Heparin is an important anticoagulation agent in TAAA surgical procedures but the use of higher levels of heparin in the present study revealed no beneficial effects. Bleeding complications is much less when heparin is used in the real-world clinical practice as ACT levels of 200.
authors.affiliation: Department of Cardiovascular Surgery, Ankara Numune Education and Research Hospital, 06330 Ankara, Turkey. yener@comu.edu.tr.
authors.forename: Ali Ümit
authors.initials: AÜ
authors.lastname: Yener
authors.forename: Mustafa Cüneyt
authors.initials: MC
authors.lastname: Çiçek
authors.forename: Serhat Bahadır
authors.initials: SB
authors.lastname: Genç
authors.forename: Turgut
authors.initials: T
authors.lastname: Özkan
authors.forename: Emre
authors.initials: E
authors.lastname: Doğan
authors.forename: Bülent Cağlar
authors.initials: BC
authors.lastname: Bilgin
authors.forename: Tezcan
authors.initials: T
authors.lastname: Akın
authors.forename: Havva
authors.initials: H
authors.lastname: Erdem
authors.forename: Handan
authors.initials: H
authors.lastname: Ankarali
mesh_terms: D000818:Animals; D017545:Aortic Aneurysm, Thoracic / Q000150:complications*; D006493:Heparin / Q000494:pharmacology*; D007150:Immunohistochemistry; D007668:Kidney / Q000098:blood supply* / Q000737:chemistry / Q000187:drug effects; D008099:Liver / Q000098:blood supply* / Q000737:chemistry / Q000187:drug effects; D008297:Male; D020011:Protective Agents / Q000494:pharmacology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000188:drug therapy*
chemical_list: D020011:Protective Agents; D006493:Heparin