Liver Transplantation Clinical Trial
Official title:
The Effect of Remote Ischemic Preconditioning on the Postoperative Liver Function in Living Donor Hepatectomy: a Randomized Clinical Trial
Liver transplantation is the gold standard treatment for patients with end-stage liver disease. Despite its outstanding success, liver transplantation still entails certain complications including ischemia-reperfusion injury. Remote ischemic preconditioning is a novel and simple therapeutic method to lessen the harmful effects of ischemia-reperfusion injury, however, the majority of remote ischemic preconditioning studies on hepatic ischemia-reperfusion injury have been animal studies. Therefore, our aim was to assess the effects of remote ischemic preconditioning on postoperative liver function in living donor hepatectomy.
Liver transplantation(LT) is the gold standard treatment for patients with end-stage liver
disease. In light of advancements in surgical techniques, immunosuppressive agents, and
perioperative critical care, the overall 3-year survival of patients undergoing LT has
exceeded 80%. Despite its outstanding success, LT still entails certain complications
including ischemia-reperfusion injury (IRI).
IRI occurs when the blood supply to an organ or tissue is temporarily cut-off and then
restored, and it is well-known as an underlying cause of primary non-function, biliary
complications, and eventual graft loss after LT. Despite many attempts to ameliorate hepatic
IRI, no definitive therapies have been established. In addition, the mechanisms of IRI remain
largely unclear.
Remote ischemic preconditioning (RIPC) is a novel and simple therapeutic method to lessen the
harmful effects of IRI. RIPC indicate that brief episodes of ischemia with intermittent
reperfusion are introduced at a remote site, leading to systemic protection against
subsequent insults as evinced on kidney, heart, liver, and other tissues. While RIPC has been
shown to reduce hepatic IRI in several small animal studies, the beneficial effects of RIPC
in hepatic IRI have been inconsistent. By far, the majority of RIPC studies on hepatic IRI
have been animal studies; hence, there are limitations relating to the lack of human clinical
trials.
Therefore, our aim was to assess the effects of RIPC on postoperative liver function in
living donor hepatectomy.
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