IMPACT OF SEVOFLURANE AND ACETYLCYSTEINE ON ISCHEMIA-REPERFUSION INJURY OF THE LIVER FROM BRAIN-DEAD DONOR
https://doi.org/10.15825/1995-1191-2013-1-39-44
Abstract
Aim. The purpose of our work was to estimate the impact of preconditioning with acetylcysteine and sevoflurane on ischemia-reperfusion injury of cadaveric donor liver with marginal features. Methods and results. In this prospective randomized controlled trial we recruited 21 heart beating donors with brain death. We assigned 11 donors to the study group, and 10 donors to the control group. Morphological characteristics of ischemia- reperfusion injury in both groups were analyzed. Conclusion. Use of pharmacological preconditioning with acetylcysteine and sevoflurane resulted in necrosis and hepatocyte apoptosis reduction as compared to the control group, thereby had a protective effect against ischemia-reperfusion injury.
About the Authors
A. E. ShcherbaS. V. Korotkov
A. F. Minov
Y. V. Slobodin
M. M. Savchuk
A. M. Dzyadzko
O. O. Rummo
References
1. Abu-Amara1 M., Gurusamy K., Hori S. Systematic re- view of randomized controlled trials of pharmacological interventions to reduce ischaemia-reperfusion injury in elective liver resection with vascular occlusion // HPB (Oxford). 2010. Vol. 12 (1). P. 4–14.
2. Beck-Schimmer B., Breitenstein S., Urech S., De Con- no E. et al. A randomized controlled trial on pharmaco- logical preconditioning in liver surgery using a volatile anesthetic // Ann. Surg. 2008. Vol. 248. P. 909–918.
3. Bussutil R., Klintmalm G. Transplantation of the liver // Elsevier. 2005. P. 186.
4. Kakizoe S., Yanaga K., Starzl T., Demetris J. Evaluation of protocol before transplantation and reperfusion biop- sies from human orthotopic liver allografts: Considera- tions of preservation and early immunological injury // Hepatology. 1990. Vol. 11. P. 932–941.
5. Kiuchi T., Oldhafer K., Schlitt H., Nashan B. et al. Back- ground and prognostic implications of perireperfusion tis- sue injuries in human liver transplants: A panel histoche- mical study // Transplantation. 1998. Vol. 66. P. 737–747.
6. Koneru B., Fisher A., He Y., Klein K. et al. Ischemic pre- conditioning in deceased donor liver transplantation: a prospective randomized clinical trial of safety and effi- cacy // Liver Transplantation. 2005. Vol. 11. P. 196–202.
7. Miller R. Millers Anesthesia // Elsevier. 2010. 617 p.
8. Ohkohchi N. Mechanisms of preservation and ischemic/ reperfusion injury in liver transplantation // Transplanta-
9. tion Proceedings. 2002. Vol. 34 (7). P. 26–35.
10. Okamoto S., Corso C., Leiderer R., Rascher W. et al. Role of hypotension in brain-death associated impair- ment of livermicrocirculation and viability // Transplant
11. Int. 2000. Vol. 13. P. 428–435.
Review
For citations:
Shcherba A.E., Korotkov S.V., Minov A.F., Slobodin Y.V., Savchuk M.M., Dzyadzko A.M., Rummo O.O. IMPACT OF SEVOFLURANE AND ACETYLCYSTEINE ON ISCHEMIA-REPERFUSION INJURY OF THE LIVER FROM BRAIN-DEAD DONOR. Russian Journal of Transplantology and Artificial Organs. 2013;15(1):39-44. (In Russ.) https://doi.org/10.15825/1995-1191-2013-1-39-44