Amelioration of liver injury by ischaemic preconditioning

Background Ischaemic preconditioning, i.e. preparatory brief ischaemia befo re subsequent longs ischaemia, can effectively protect the heart from ischa emia-reperfusion injury in animals. The purpose of this study was to demons trate the same phenomenon in the liver. Methods Using warm ischaemia-reperfusion of 70 per cent of the liver follow ed by resection of the non-ischaemic portion in rats. livers with 10 min of ischaemic preconditioning, i.e. 10 min of warm ischaemia and reperfusion, were compared with those that had not been subjected to such a manoeuvre. Results At 120 min after reperfusion following 40 min of warm ischaemia, th e livers with 10 min of ischaemic preconditioning had a significantly lower mean(s.d.) serum alanine aminotransferase level (492(217) versus 1236(695) units/l; P<0.005) and lactic dehydrogenase level (7905(4002) versus 15 066 (9201) units/l; P <0.05), as well as a higher bile output (0.12(0.03) versu s 0.09(0.04) ml per g liver; P<0.05) and liver tissue adenosine 5'-triphosp hate level (78(13) versus 61(11) per cent; P<0.05) than the control livers. The necrosis rate, histologically defined as the percentage of necrotic ar ea in given liver sections, was reduced significantly by this manoeuvre (me an(s.d.) 1.3(1.3) versus 5.3(1.7) per cent; P<0.05). Conclusion Ischaemic preconditioning exerts a protective effect on hepatic warm ischaemia-reperfusion injury. Such a manoeuvre may be useful for hepat ic resection in the clinical setting.