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Ischemic preconditioning and intermittent clamping confer protection against ischemic injury in the cirrhotic mouse liver

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Author(s)
In-Seon LeeRolf GrafJae Hwi JangKoo-Jeong KangYuna KangPierre-Alain Clavien
Keimyung Author(s)
Kang, Koo JeongKang, Yu Na
Department
Dept. of Surgery (외과학)
Dept. of Pathology (병리학)
Institute for Cancer Research (암연구소)
Journal Title
Liver Transplantation
Issued Date
2008
Volume
14
Issue
7
Abstract
Surgery on cirrhotic livers is fraught with complications, and many surgeons refrain from operating on patients with cirrhosis.
Surgical procedures include temporal occlusion of blood flow resulting in ischemia. The mechanisms of protective strategies
to prevent ischemic injury in patients with cirrhosis are not fully understood. The aim of this study was to evaluate how the
cirrhotic liver tolerates an ischemic insult, whether mechanisms other than those observed in the normal liver are active, and
whether intermittent clamping and preconditioning, which are known as safe surgical strategies in normal and steatotic livers,
confer protection to the cirrhotic liver. We applied partial hepatic inflow occlusion to cirrhotic mice fed carbon tetrachloride
according to different vascular occlusion protocols: intermittent clamping with 15 or 30 minute cycles of ischemia or ischemic
preconditioning prior to 60 or 75 minutes of ischemia. Continuous ischemia (60 or 75 minutes) served as controls. The results
showed that the cirrhotic liver was significantly more susceptible to 60 minutes of ischemia than the normal liver. Apoptosis was
higher in the normal liver, whereas necrosis was a predominant feature in the cirrhotic liver. Both protocols of intermittent
vascular occlusion and ischemic preconditioning dramatically prevented injury compared to continuous occlusion for 60
minutes. This protection was associated with reduced necrosis and apoptosis, and particularly reduced activation of the
apoptotic pathway through mitochondria. In conclusion, this study extends the protective effects of ischemic preconditioning
and intermittent clamping to the cirrhotic liver, highlighting a diminished apoptotic pathway with dramatic improvement in the
development of necrosis. Liver Transpl 14:980-988, 2008.
Keimyung Author(s)(Kor)
강구정
강유나
Publisher
School of Medicine
Citation
In-Seon Lee et al. (2008). Ischemic preconditioning and intermittent clamping confer protection against ischemic injury in the cirrhotic mouse liver. Liver Transplantation, 14(7), 980–988. doi: 10.1002/lt.21467
Type
Article
ISSN
1527-6465
DOI
10.1002/lt.21467
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33400
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Pathology (병리학)
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
3. Research Institutues (연구소) > Institute for Cancer Research (암연구소)
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