The Effect of Remote Ischemic Preconditioning in Living Donor Hepatectomy
Condition: Tissue Donors; Liver Transplantation; Ischemia Reperfusion Injury
MeSH terms: Reperfusion Injury; Ischemia
Study type: Interventional

Summary: 
      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.
    

Detailed description: 
      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.
    

Intervention name(s): remote ischemic preconditioning
Intervention type(s): Procedure
Intervention description(s): Remote ischemic preconditioning was performed following anesthesia induction in donors. The protocol involves 3 cycles of 5-minute inflation of a blood pressure cuff to 200 mm Hg to one upper arm, followed by 5-minute reperfusion with the cuff deflated
Other intervention name(s): RIPC
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: study group : remote ischemic preconditioning control group : none
Masking: Double (Participant, Investigator)
Primary purpose: Prevention
Keywords: remote ischemic preconditioning; liver donors