Protective effect of ischemic preconditioning on liver ischemic-reperfusion injury of liver transplant in rats

Objective To investigate the protective effect and mechanism of warm ischemic preconditioning of on liver cold ischemic-reperfusion injury of donor liver in rats. Methods Male Sprague Dawley rats were used as donors and recipients of orthotopic liver transplantation, the cold ischemia period and anhepatic phase was 120 min and 16～20 min respectively. Rats were randomly divided into 3 groups: sham-operation group, liver transplantation group, and ischemic pre-conditioning(IP) group. IP was performed with 5-min ischemia followed by 5-min reperfusion. Results After operation, the serum levels of ALT and superoxide were significantly higher in the groups of liver transplantation and IP group than in the sham-operation group(P0.05), and they were lower in IP group than those in liver transplantation group(P0.05), but activity of anti-oxidase was higher in IP group(P0.05).Plasma NO concentrations were marked higher in the groups of liver transplantation and IP at 2h, 4h, 24h and 72 h after operation than those in sham-operation group(P0.05), and at 72 h were higher in liver transplantation than those in IP and sham-operation group, and higher in IP group than in sham-operation group. Serum TNF-α levels were obviously increased in liver transplantation than those in IP and sham-operation groups (P0.05).Conclusions Warm IP for donor liver could obviously protect rat liver graft from cold ischemic-reperfusion injury, its mechanism might be that IP can rapidly increase serum NO level, maintain a steady level of serum NO, decrease TNF-α generation from inflammatory cells and thus diminish cellular injury of liver graft.