Ischemic pre- and post-conditioning: current clinical applications Pré et post conditionnement ischémique : applications cliniques actuelles

Summary Ischemic conditioning is a phenomenon through which short sequences of ischemiareperfusion applied to an organ confer some degree of protection towards future ischemic insults. This phenomenon was ?rst 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 bene?ts 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 iow to organs and protection against apoptosis. In the ?eld 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