Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
Clinical Center for Investigation, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
World J Gastroenterol. 2021 Jan 28;27(4):345-357. doi: 10.3748/wjg.v27.i4.345.
Studies suggested that remote ischemic preconditioning (RIPC) may effectively lessen the harmful effects of ischemia reperfusion injury during organ transplantation surgery.
To investigate the protective effects of RIPC on living liver donors and recipients following pediatric liver transplantation.
From January 2016 to January 2019 at Renji Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, 208 donors were recruited and randomly assigned to four groups: S-RIPC group (no intervention; = 55), D-RIPC group (donors received RIPC; = 51), R-RIPC group (recipients received RIPC, = 51) and DR-RIPC group (both donors and recipients received RIPC; = 51). We primarily evaluated postoperative liver function among donors and recipients and incidences of early allograft dysfunction, primary nonfunction and postoperative complications among recipients.
RIPC did not significantly improve alanine transaminase and aspartate aminotransferase levels among donors and recipients or decrease the incidences of early allograft dysfunction, primary nonfunction, and postoperative complications among recipients. Limited protective effects were observed, including a lower creatinine level in the D-RIPC group than in the S-RIPC group on postoperative day 0 ( < 0.05). However, no significant improvements were found in donors who received RIPC. Furthermore, RIPC had no effects on the overall survival of recipients.
The protective effects of RIPC were limited for recipients who received living liver transplantation, and no significant improvement of the prognosis was observed in recipients.
研究表明，远程缺血预处理（RIPC）可能有效减轻器官移植手术中缺血再灌注损伤的有害影响。
研究 RIPC 对小儿肝移植供体和受体的保护作用。
本研究于 2016 年 1 月至 2019 年 1 月在上海交通大学医学院附属仁济医院纳入 208 例供体，随机分为四组：S-RIPC 组（无干预；n = 55）、D-RIPC 组（供体接受 RIPC；n = 51）、R-RIPC 组（受体接受 RIPC；n = 51）和 DR-RIPC 组（供体和受体均接受 RIPC；n = 51）。主要评估供体和受体术后肝功能，受体早期移植物功能障碍、原发性无功能和术后并发症的发生率。
RIPC 并未显著改善供体和受体的丙氨酸转氨酶和天冬氨酸转氨酶水平，也未降低受体早期移植物功能障碍、原发性无功能和术后并发症的发生率。仅观察到有限的保护作用，包括 D-RIPC 组术后第 0 天的肌酐水平低于 S-RIPC 组（<0.05）。然而，接受 RIPC 的供体并未出现明显改善。此外，RIPC 对受体的总生存率无影响。
RIPC 对接受活体肝移植的受体的保护作用有限，且对受体的预后无显著改善。
