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Abdo EE, Figueira ERR, Rocha-Filho JA, Chaib E, D'Albuquerque LAC, Bacchella T. PRELIMINARY RESULTS OF TOPICAL HEPATIC HYPOTHERMIA IN A MODEL OF LIVER ISCHEMIA/REPERFUSION INJURY IN RATS. ARQUIVOS DE GASTROENTEROLOGIA 2017; 54:246-249. [PMID: 28723980 DOI: 10.1590/s0004-2803.201700000-30] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 04/12/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Ischemia/reperfusion causes organ damage but it is mandatory in hepatic transplantation, trauma and other complex liver surgeries, when Pringle maneuver is applied to minimize bleeding during these procedures. It is well known that liver ischemia/reperfusion leads to microcirculatory disturbance and cellular injury. In this setting hypothermia is known to reduce oxygen demand, lowering intracellular metabolism. OBJECTIVE: To evaluate the effects of hypothermia in liver ischemia/reperfusion injury, using a new model of topic isolated liver hypothermia. METHODS We used male Wistar rats weighting about 250 grams, kept in ad libitum feeding regime and randomly divided into two groups of nine animals: 1) Normothermic group, rats were submitted to normothermic ischemia of the median and left hepatic lobes, with subsequent resection of right and caudate lobes during liver reperfusion; and 2) Hypothermic group, rats were submitted to liver ischemia under hypothermia at 10°C. Liver ischemia was performed for 45 minutes. The animals were euthanized 48 hours after liver reperfusion for blood and liver tissue sampling. RESULTS The transaminases analyses showed a significant decrease of AST and ALT in Hypothermic group (P<0.01) compared to Normothermic group (1403±1234 x 454±213 and 730±680 x 271±211 U/L, respectively). Histology showed severe necrosis in 50% and mild necrosis in 50% of cases in Normothermic group, but severe necrosis in 10% and mild or absent necrosis 90% of the cases in hypothermic group. CONCLUSION: A simplified model of liver ischemia/reperfusion that simulates orthotopic liver autotransplantion was demonstrated. Topical hypothermia of isolated hepatic lobules showed liver protection, being a viable and practical method for any kind of in vivo liver preservation study.
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Affiliation(s)
- Emilio Elias Abdo
- Hospital das Clínicas, Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, Divisão de Cirurgia Digestiva, São Paulo, SP, Brasil.,Hospital das Clínicas, Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, Laboratório de Investigação Médica LIM37, São Paulo, SP, Brasil
| | - Estela Regina Ramos Figueira
- Hospital das Clínicas, Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, Divisão de Cirurgia Digestiva, São Paulo, SP, Brasil.,Hospital das Clínicas, Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, Laboratório de Investigação Médica LIM37, São Paulo, SP, Brasil
| | - Joel Avancini Rocha-Filho
- Hospital das Clínicas, Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, Laboratório de Investigação Médica LIM37, São Paulo, SP, Brasil.,Hospital das Clínicas, Universidade de São Paulo, Faculdade de Medicina, Departamento de Cirurgia, Disciplina de Anestesiologia, São Paulo, SP, Brasil
| | - Eleazar Chaib
- Hospital das Clínicas, Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, Laboratório de Investigação Médica LIM37, São Paulo, SP, Brasil.,Hospital das Clínicas, Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, Divisão de Transplante de Fígado e Gastrointestinal, São Paulo, SP, Brasil
| | - Luiz Augusto Carneiro D'Albuquerque
- Hospital das Clínicas, Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, Laboratório de Investigação Médica LIM37, São Paulo, SP, Brasil.,Hospital das Clínicas, Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, Divisão de Transplante de Fígado e Gastrointestinal, São Paulo, SP, Brasil
| | - Telesforo Bacchella
- Hospital das Clínicas, Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, Divisão de Cirurgia Digestiva, São Paulo, SP, Brasil.,Hospital das Clínicas, Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, Laboratório de Investigação Médica LIM37, São Paulo, SP, Brasil
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The current state of knowledge of hepatic ischemia-reperfusion injury based on its study in experimental models. J Biomed Biotechnol 2012; 2012:298657. [PMID: 22649277 PMCID: PMC3357607 DOI: 10.1155/2012/298657] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 02/23/2012] [Indexed: 12/11/2022] Open
Abstract
The present review focuses on the numerous experimental models used to study the complexity of hepatic ischemia/reperfusion (I/R) injury. Although experimental models of hepatic I/R injury represent a compromise between the clinical reality and experimental simplification, the clinical transfer of experimental results is problematic because of anatomical and physiological differences and the inevitable simplification of experimental work. In this review, the strengths and limitations of the various models of hepatic I/R are discussed. Several strategies to protect the liver from I/R injury have been developed in animal models and, some of these, might find their way into clinical practice. We also attempt to highlight the fact that the mechanisms responsible for hepatic I/R injury depend on the experimental model used, and therefore the therapeutic strategies also differ according to the model used. Thus, the choice of model must therefore be adapted to the clinical question being answered.
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Figueira ERR, Bacchella T, Coelho AMM, Sampietre SN, Molan NAT, Leitão RMC, Machado MCC. Timing-dependent protection of hypertonic saline solution administration in experimental liver ischemia/reperfusion injury. Surgery 2009; 147:415-23. [PMID: 20004454 DOI: 10.1016/j.surg.2009.10.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2008] [Accepted: 10/05/2009] [Indexed: 01/05/2023]
Abstract
BACKGROUND During liver ischemia, the decrease in mitochondrial energy causes cellular damage that is aggravated after reperfusion. This injury can trigger a systemic inflammatory syndrome, also producing remote organ damage. Several substances have been employed to decrease this inflammatory response during liver transplantation, liver resections, and hypovolemic shock. The aim of this study was to evaluate the effects of hypertonic saline solution and the best timing of administration to prevent organ injury during experimental liver ischemia/reperfusion. METHODS Rats underwent 1 hr of warm liver ischemia followed by reperfusion. Eighty-four rats were allocated into 6 groups: sham group, control of ischemia group (C), pre-ischemia treated NaCl 0.9% (ISS) and NaCl 7.5% (HTS) groups, pre-reperfusion ISS, and HTS groups. Blood and tissue samples were collected 4 hr after reperfusion. RESULTS HTS showed beneficial effects in prevention of liver ischemia/reperfusion injury. HTS groups developed increases in AST and ALT levels that were significantly less than ISS groups; however, the HTS pre-reperfusion group showed levels significantly less than the HTS pre-ischemia group. No differences in IL-6 and IL-10 levels were observed. A significant decrease in mitochondrial dysfunction as well as hepatic edema was observed in the HTS pre-reperfusion group. Pulmonary vascular permeability was significantly less in the pre-reperfusion HTS group compared to the ISS group. No differences in myeloperoxidase activity were observed. The liver histologic score was significantly less in the pre-reperfusion HTS group compared to the pre-ischemia HTS group. CONCLUSION HTS ameliorated local and systemic injuries in experimental liver ischemia/reperfusion. Infusion of HTS in the pre-reperfusion period may be an important adjunct to accomplish the best results.
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Affiliation(s)
- Estela Regina Ramos Figueira
- Liver Transplantation Service, Department of Surgery, University of São Paulo Medical School, São Paulo, Brazil.
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Abstract
Hepatic ischemia/reperfusion injury has so far been investigated in various experimental models. A clinical transfer of experimental results is, however, problematic because of anatomical and physiological differences and also the inevitable simplification of experimental work. The choice of model must therefore be adapted to the clinical question to be answered. The simplest procedure for inducing normothermic ischemia is to clamp the hepatoduodenal ligament. Models that do not avert portal congestion are regarded as unsuitable. Our current understanding of the pathogenesis of ischemia/reperfusion injury depends mainly on studies whose authors have investigated either global liver ischemia with a portocaval shunt, spleen transposition and in the isolated perfused system, or partial ischemia. This review is a critical examination of various approaches to the study of normothermic hepatic ischemia in experimental animals.
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Affiliation(s)
- H U Spiegel
- Surgical Research, Department of General Surgery, University Hospital Muenster, Muenster, Germany.
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