scholarly journals Impact of preoperative steroids administration on ischemia-reperfusion injury and systemic responses in liver surgery: A prospective randomized study

2006 ◽  
Vol 12 (6) ◽  
pp. 941-949 ◽  
Author(s):  
Luca Aldrighetti ◽  
Carlo Pulitanò ◽  
Marcella Arru ◽  
Renato Finazzi ◽  
Marco Catena ◽  
...  
Keyword(s):  
Reperfusion Injury ◽  
Liver Surgery ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Systemic Responses

scholarly journals Impact of Ischemic Preconditioning on Outcome in Clinical Liver Surgery: A Systematic Review

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Michael J. J. Chu ◽  
Ryash Vather ◽  
Anthony J. R. Hickey ◽  
Anthony R. J. Phillips ◽  
Adam S. J. R. Bartlett
Keyword(s):  
Systematic Review ◽  
Liver Transplantation ◽  
Liver Resection ◽  
Reperfusion Injury ◽  
Ischemic Preconditioning ◽  
Liver Surgery ◽  
Clinical Studies ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Hepatocellular Damage

Background. Ischemia-reperfusion injury is a major cause of post-liver-surgery complications. Ischemic preconditioning (IPC) has been demonstrated to protect against ischemia-reperfusion injury. Clinical studies have examined IPC in liver surgery but with conflicting results. This systematic review aimed to evaluate the effects of IPC on outcome in clinical liver surgery.Methods. An electronic search of OVID Medline and Embase databases was performed to identify studies that reported outcomes in patients undergoing liver surgery subjected to IPC. Basic descriptive statistics were used to summarise data from individual clinical studies.Results. 1093 articles were identified, of which 24 met the inclusion criteria. Seven topics were selected and analysed by subgroup. There were 10 studies in cadaveric liver transplantation, 2 in living-related liver transplantation, and 12 in liver resection. IPC decreases hepatocellular damage in liver surgery as determined by transaminases but does not translate to any significant clinical benefit in orthotopic liver transplant or liver resection.Conclusions. Available clinical evidence does not support routine use of IPC in liver surgery as it does not offer any apparent benefit in perioperative outcome. Further clinical studies will need to be carried out to determine the subset of patients that will benefit from IPC.

Molecular mechanisms of hepatic ischemia-reperfusion injury and preconditioning

2003 ◽  
Vol 284 (1) ◽  
pp. G15-G26 ◽  
Author(s):  
Hartmut Jaeschke
Keyword(s):  
Reperfusion Injury ◽  
Liver Surgery ◽  
Molecular Mechanisms ◽  
Ischemia Reperfusion Injury ◽  
Current Knowledge ◽  
Ischemia Reperfusion ◽  
Oxidant Stress ◽  
Cellular Mechanisms ◽  
Hepatic Ischemia ◽  
Hepatic Ischemia Reperfusion

Ischemia-reperfusion injury is, at least in part, responsible for the morbidity associated with liver surgery under total vascular exclusion or after liver transplantation. The pathophysiology of hepatic ischemia-reperfusion includes a number of mechanisms that contribute to various degrees in the overall injury. Some of the topics discussed in this review include cellular mechanisms of injury, formation of pro- and anti-inflammatory mediators, expression of adhesion molecules, and the role of oxidant stress during the inflammatory response. Furthermore, the roles of nitric oxide in preventing microcirculatory disturbances and as a substrate for peroxynitrite formation are reviewed. In addition, emerging mechanisms of protection by ischemic preconditioning are discussed. On the basis of current knowledge, preconditioning or pharmacological interventions that mimic these effects have the greatest potential to improve clinical outcome in liver surgery involving ischemic stress and reperfusion.

scholarly journals Ischemia/Reperfusion Injury in Liver Surgery and Transplantation

HPB Surgery ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-1 ◽  
Author(s):  
Peter Schemmer ◽  
John J. Lemasters ◽  
Pierre-Alain Clavien
Keyword(s):  
Reperfusion Injury ◽  
Liver Surgery ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion
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