Ischemic preconditioning vs adenosine vs prostaglandin E1 for protection against liver ischemia/reperfusion injury

Abstract Ischemia/reperfusion injury is still a major cause of morbidity and mortality during liver surgery and transplantation. A variety ofsurgical and pharmacological therapeutic strategies have been investigated to minimize the effects of ischemia/reperfusion. Theaim of our study was to analyze and compare preventive influences of ischemic preconditioning, adenosine and prostaglandinE1 in the experimental model of hepatic ischemia/reperfusion injury. Adult chinchilla rabbits were divided into four groups:10 rabbits subjected to liver ischemic preconditioning (3-min period of inflow occlusion followed by a 5-min period of reperfusion)followed by 45 min of Pringle maneuver; 10 rabbits subjected to pre-treatment with intraportal injection of adenosine followedby 45 min of Pringle maneuver; 10 rabbits subjected to pre-treatment with intraportal injection of prostaglandin E1 followed by45 min of Pringle maneuver; and control group of 10 rabbits subjected to 45 min of inflow liver ischemia without anypreconditioning. On the second postoperative day, blood samples were obtained and biochemical parameters of liver functionwere measured and compared. Liver tissue samples were also obtained and histopathological changes were compared. Basedon biochemical and histopathological parameters, it was demonstrated that ischemic preconditioning provided the bestprotection against hepatic ischemia/reperfusion injury. This was probably due to a wider range of mechanisms of action of thismethod oriented to reduce oxidative stress and inflammation, and restore liver microcirculation and hepatocyte energycompared to the examined pharmacological strategies.Key words: Liver ischemia/reperfusion injury; Ischemic preconditioning; Adenosine; Prostaglandin E1; Protection