Basic Research
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 14, 2006; 12(42): 6812-6817
Published online Nov 14, 2006. doi: 10.3748/wjg.v12.i42.6812
Reduction of ischemia reperfusion injury after liver resection and hepatic inflow occlusion by α-lipoic acid in humans
Fritz Dünschede, Kirsten Erbes, Achim Kircher, Stefanie Westermann, Joachim Seifert, Arno Schad, Kempski Oliver, Alexandra K Kiemer, Junginger Theodor
Fritz Dünschede, Achim Kircher, Stefanie Westermann, Joachim Seifert, Kirstin Erbes, Theodor Junginger, Department of General and Abdominal Surgery, University hospital Mainz, Germany
Arno Schad, Institute for Pathology, University hospital Mainz, Germany
Alexandra K Kiemer, Department of Pharmacy, Pharmaceutical Biology, Saarland University, Germany
Kempski Oliver, Institute for Neurosurgical Pathophysiology, University hospital Mainz, Germany
Author contributions: All authors contributed equally to the work.
Correspondence to: Friedrich Duenschede, MD, University hospital Mainz, Department of General and Abdominal Surgery, Langenbeckstr. 1, Mainz 55131, Germany. duenschede@ach.klinik.uni-mainz.de
Telephone: +49-6131-177291 Fax: +49-6131-176630
Received: June 8, 2006
Revised: August 16, 2006
Accepted: August 27, 2006
Published online: November 14, 2006
Abstract

AIM: To evaluate the protective effects of preconditioning by α-lipoic acid (LA) in patients undergoing hepatic resection under inflow occlusion of the liver.

METHODS: Twenty-four patients undergoing liver resection for various reasons either received 600 mg LA or NaCl 15 min before transection performed under inflow occlusion of the liver. Blood samples and liver wedge biopsy samples were obtained after opening of the abdomen immediately after inflow occlusion of the liver, and 30 min after the end of inflow occlusion of the liver.

RESULTS: Serum levels of aspartate transferase and alanine transferase were reduced at all time points in patients who received LA in comparison to those who received NaCL. This was accompanied by reduced histomorphological features of oncosis. We observed TUNEL-positive hepatocytes in the livers of the untreated patients, especially after 30 min of ischemia. LA attenuated this increase of TUNEL-positive hepatocytes. Under preconditioning with LA, ATP content was significantly enhanced after 30 min of ischemia and after 30 min of reperfusion.

CONCLUSION: This is the first report on the potential for LA reducing ischemia/reperfusion injury (IRI) of the liver in humans who were undergoing liver surgery. Beside its simple and rapid application, side effects did not occur. LA might therefore represent a new strategy against hepatic IRI in humans.

Keywords: Liver ischemia, Pringle manoeuvre, Pharmac-ological pre-treatment, Liver preconditioning, Apoptosis, Adenosine triphosphate