title: Ischemic pre- and post-conditioning: current clinical applications.
abstract: Ischemic conditioning is a phenomenon through which short sequences of ischemia-reperfusion applied to an organ confer some degree of protection towards future ischemic insults. This phenomenon was first observed in the mid-1980s in cardiac surgery, and has been since widely studied in different settings. Different sort of ischemic conditioning exist: local vs remote, direct or pharmacological, and with different timeframes of protection. Ischemic conditioning seems especially suited to applications in transplantation since schedules of both cold and warm ischemia, as well as reperfusion, are carefully and easily controlled, and the benefits of protecting fragile organs against ischemia-reperfusion injuries might help widen the pool of possible grafts and ensure better graft function and survival. The pathways through which ischemic conditioning work are many, offering both preservation of cell energy, protection against oxidative stress, better blood flow to organs and protection against apoptosis. In the field of pharmacological conditioning, which tries to mimic the protective effects of traditional ischemic conditioning without the potential side-effects associated with vessel clamping, many common-use drugs including anesthetics have been shown to be effective. Significant results have been obtained in small animal models, but while ischemic conditioning is successfully used in cardiac surgery, studies in large animal models and human applications in liver and kidney transplantation are still inconclusive.
authors.affiliation: Inserm U1082; université de Poitiers, faculté de Médecine et Pharmacie, 86000 Poitiers, France; Service d'Urologie et de Transplantation rénale, hôpital Lapeyronie, 34295 Montpellier, France. Electronic address: rodolphethuret@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Thuret
authors.affiliation: Inserm U1082; université de Poitiers, faculté de Médecine et Pharmacie, 86000 Poitiers, France; Service d'Urologie, CHU de Poitiers La Miletrie, 86021 Poitiers, France.
authors.forename: T
authors.initials: T
authors.lastname: Saint Yves
authors.affiliation: Service d'Urologie, CHU Cote-de-Nacre, 14000 Caen, France.
authors.forename: X
authors.initials: X
authors.lastname: Tillou
authors.affiliation: Inserm U1082; université de Poitiers, faculté de Médecine et Pharmacie, 86000 Poitiers, France; CHU de Poitiers, Département de Biochimie, 86000 Poitiers, France.
authors.forename: N
authors.initials: N
authors.lastname: Chatauret
authors.affiliation: Inserm U1082; université de Poitiers, faculté de Médecine et Pharmacie, 86000 Poitiers, France; CHU de Poitiers, Département de Biochimie, 86000 Poitiers, France.
authors.forename: R
authors.initials: R
authors.lastname: Thuillier
authors.affiliation: Inserm U1082; université de Poitiers, faculté de Médecine et Pharmacie, 86000 Poitiers, France; Service d'Urologie et de Transplantation rénale, hôpital de la Pitié-Salpêtrière, 75013 Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Barrou
authors.affiliation: Inserm U1082; université de Poitiers, faculté de Médecine et Pharmacie, 86000 Poitiers, France; Service d'Urologie et de Transplantation rénale, hôpital de la Pitié-Salpêtrière, 75013 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Billault
mesh_terms: D000818:Animals; D006801:Humans; D057775:Ischemic Postconditioning; D019194:Ischemic Preconditioning; D007668:Kidney / Q000098:blood supply*; D016030:Kidney Transplantation
keywords: Conditionnement ischémique; Ischemia-reperfusion injuries; Ischemic conditioning; Kidney transplantation; Lésions d’ischémie reperfusion; Transplantation rénale