title: Is Ischemic Preconditioning a Useful Therapeutic Strategy in Liver Transplantation? Results from the First Pilot Study in Mexico.
abstract: OBJECTIVE
  The protective effect of ischemic preconditioning (IP) in liver transplantation (LT) has been studied with controversial results. We undertook this study to investigate whether IP of cadaveric donor livers is protective to allografts.
  
  
  METHODS
  IP (LT + IP, n = 6) was induced by 10-min hilar clamping. These were compared to cadaver donors with no IP (LT, n = 7). Clinical data and blood were obtained in donors and recipients for biochemical and inflammatory mediator (IM) measurements (P-selectin, leukotriene B4, myeloperoxidase, ICAM-1, IL-1, IL-6, and TNF-α). Liver tissue samples were obtained from donors and recipients (90 min after reperfusion).
  
  
  RESULTS
  No significant differences were found in demographic characteristics between donors and recipients. When comparing both groups (LT + IP vs. LT only), ICU stay was longer in LT + IP group. For biochemical parameters, a significant difference was found only with a higher total bilirubin at postoperative day 3 in LT + IP group. There was no statistical difference in IM between LT and LT + IP groups at different stages of the study. Histological analysis of donor grafts indicated the presence of steatosis (50%) in one graft from the LT + IP group. However, in post-reperfusion biopsies neither neutrophil infiltration nor grade of necrosis showed significant difference between groups. No incidence of primary graft nonfunction (PGNF) was observed and graft and patient survival was similar in the two groups at 24 months.
  
  
  CONCLUSIONS
  IP does not seem to protect against I/R injury in cadaveric LT, and no PGNF was seen.
authors.affiliation: Transplant Service, University Hospital "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, México.
authors.forename: Homero A
authors.initials: HA
authors.lastname: Zapata-Chavira
authors.affiliation: Liver Unit, University Hospital "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, México.
authors.forename: Paula
authors.initials: P
authors.lastname: Cordero-Pérez
authors.affiliation: Hospital Regional de Alta Especialidad de Ciudad Victoria "Bicentenario 2010", Ciudad Victoria, México.
authors.forename: Araní
authors.initials: A
authors.lastname: Casillas-Ramírez
authors.affiliation: Transplant Service, University Hospital "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, México.
authors.forename: Miguel M
authors.initials: MM
authors.lastname: Escobedo-Villarreal
authors.affiliation: Transplant Service, University Hospital "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, México.
authors.forename: Edelmiro
authors.initials: E
authors.lastname: Pérez-Rodríguez
authors.affiliation: Liver Unit, University Hospital "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, México.
authors.forename: Liliana
authors.initials: L
authors.lastname: Torres-González
authors.affiliation: Liver Unit, University Hospital "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, México.
authors.forename: Carlos
authors.initials: C
authors.lastname: Camara-Lemarroy
authors.affiliation: Transplant Service, University Hospital "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, México.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Hernández-Guedea
authors.affiliation: Pathology Department, University Hospital "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, México.
authors.forename: Eloy
authors.initials: E
authors.lastname: Caballero-Mendoza
authors.affiliation: Liver Unit, University Hospital "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, México. Electronic address: linda_uanl@hotmail.com.
authors.forename: Linda E
authors.initials: LE
authors.lastname: Muñoz-Espinosa
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002102:Cadaver; D058625:End Stage Liver Disease / Q000097:blood / Q000601:surgery*; D005260:Female; D006801:Humans; D019194:Ischemic Preconditioning; D008099:Liver / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008800:Mexico; D008875:Middle Aged; D010865:Pilot Projects; D015427:Reperfusion Injury / Q000209:etiology / Q000517:prevention & control*; D014019:Tissue Donors; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Ischemia/reperfusion injury; Ischemic preconditioning; Liver transplantation