title: Effects of preoperative statin on liver reperfusion injury in major hepatic resection: a pilot study.
abstract: During major liver resection, ischemia reperfusion injury occurs resulting in adverse outcome. Animal studies have demonstrated the beneficial effect of statins on hepatic ischemic injury, but no clinical studies have been performed. Twenty consecutive patients undergoing major hepatic resection were included and were randomized into two groups. The study group (n = 10) patients received oral atorvastatin 40 mg for 3 days prior to surgery, including the day of surgery, and the control group (n = 10) received a placebo. Outcomes were assessed at 4, 24, and 72 h by measurement of serum liver enzymes and cytokines-IL-1, IL-6, CRP, and TNF α. The two groups were evenly matched for demographic and perioperative variables. The AST levels were significantly higher in the control group compared with the study group at 4 h (909.60 ± 222 vs. 362.6 ± 129 U/L), 24 h (215.30 ± 86.9 vs. 605.30 ± 186.1 U/L) and 72 h (84.30 ± 32.7 vs. 204.70 ± 67.5) (p < 0.001). Plasma IL-1 values in the study group showed significantly lower values compared with the control group (p < 0.001) postoperatively. Plasma IL-6 values postoperatively showed significantly lower mean values as compared with the mean of the control population (p < 0.001). TNF α values at 4, 24, and 72 h postoperatively comparable in the two groups (p = 0.011) (p = 0.096) and (p = 0.237), respectively. Statins have the potential for pharmacological prevention of IRI. Further studies would be needed to substantiate the role of statins in prevention of IRI during liver resection.
  
  
  BACKGROUND
  PGIMER, Chandigarh-NK/1081/MS/12182-83.
authors.affiliation: Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Shashwat
authors.initials: S
authors.lastname: Sarin
authors.affiliation: Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India. kamanlil@yahoo.com.
authors.forename: Lileswar
authors.initials: L
authors.lastname: Kaman
authors.affiliation: Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Divya
authors.initials: D
authors.lastname: Dahiya
authors.affiliation: Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Arunanshu
authors.initials: A
authors.lastname: Behera
authors.affiliation: Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Bikash
authors.initials: B
authors.lastname: Medhi
authors.affiliation: Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Chawla
mesh_terms: D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008099:Liver / Q000098:blood supply* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D015427:Reperfusion Injury / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Cytokines; Hepatic resection; Ischemic reperfusion injury; Statins