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Ischemic preconditioning: tolerance to hepatic ischemia-reperfusion injury A. Serafín1, L. Fernández-Zabalegui1, N. Prats2, Z.Y. Wu3, J. Roselló-Catafau1 and C. Peralta1 1Department of Experimental Pathology, Instituto de Investigaciones Biomédicas de Barcelona-Consejo Superior de Investigaciones Científicas, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain, 2Veterinary School, Universitat Autònoma de Barcelona, Barcelona, Spain and 3General Surgery Division, Renji Hospital, Shanghai, China Offprint requests to: Dr. Joan Roselló-Catafau, Department of Experimental Pathology, Instituto de Investigaciones Biomédicas de Barcelona, IDIBAPS-CSIC, C/ Rosellón 161, 6ª y 7ª planta, 08036-Barcelona, Spain. Fax: 34-933638301. e-mail: jrcbam@iibb.csic.es
Summary. Hepatic ischemia-reperfusion (I/R) injury still remains an unresolved problem in both liver resectional surgery and liver transplantation and may be responsible for liver failure, lung injury and death. The current review summarizes the findings reported to date on the effectiveness of ischemic preconditioning against liver and lung damage associated with hepatic I/R injury and the underlying protective mechanisms. The effect of ischemic preconditioning on the mechanisms potentially involved in hepatic I/R injury, including alterations in energy metabolism, neutrophil accumulation, microcirculatory disturbances, formation of proinflammatory mediators, such as endothelin and tumor necrosis factor-alpha, and reactive oxygen species generation have been evaluated. In this review, we address the role of preconditioning in the increased vulnerability of fatty livers to hepatic I/R injury. The effectiveness of ischemic preconditioning versus pharmacological strategies that could simulate the benefits of liver preconditioning has been also discussed. Histol. Histopathol 19, 281-289 (2004) Key words: Ischemia,
Reperfusion, Liver, Preconditioning, Steatosis |