THE EFFECTS OF TOPICAL HYPOTHERMIA, METHYLPREDNISOLONE AND BN 52021 ON HEPATIC ISCHEMIA/REPERFUSION INJURY
İBRAHİM TAÇYILDIZ, MUSTAFA ALDEMİR, SADULLAH GİRGİN, HÜSEYİN BÜYÜKBAYRAM, BİLSEL BAÇ
Dicle Üniversitesi Tıp Fakültesi, Genel Cerrahi, ABD, DİYARBAKIR
This study was undertaken to investigate the effectiveness of topical hypothermia, methylprednisolone and BN 52021 on ischemia/reperfusion induced liver injury. The liver is one of the organs most vulnerable to ischemia because of its high metabolic state. Occlusion of the portal triad is often required in complex hepatic surgery in order to decrease parenchymal bleeding. Liver failure due to ischemia-reperfusion injury is a serious problem during liver surgery. Fifty male Sprague-Dawley rats (200-225 gr)were divided into 5 groups each containing 10 rats. Midline laparatomy was fulfilled on all the rats under ketamine anesthesia. In group 1 (Sham), the hepatoduodenal ligament was dissected without any drug administration. In group 2 (I/R), the ischemia (for 45 min)/ reperfusion (for 45 min) was performed and received no further treatment. In group 3 (Hypothermia), the ischemia plus topical cooling (for45 min) and reperfusion (for 45 min) was fulfilled. In the group 4 (Steroid), the I/R was performed and methylprednisolone (30 mg/kg) was administered. In group 5 (BN 52021), the I/R was performed and BN 52021 (100 mg/kg) was given before ischemia. Liver, ileum and blood samples (for MDA, ALT, AST, LDH and ileal mucosal injury score)were obtained. The levels of ALT, AST, LDH,MDA (ileal, hepatic) and ileal injury score in group I/R were significantly higher than those of group sham(p<0.0001).When group I/R was compared with group hipothermia, there were no significant differences with regard to AST, ileal MDA and ileal injury score(p>0.05), whereas levels of ALT, LDH and hepatic MDA were significantly higher (p<0.0001,0.0001 <0.000 1, respectively). When group I/R was compared with group steroid and group BN 52021, it was determined that those agents had significant protective effects on hepatic and ileal injuries (p<0.0001).It was determined that topical hypothermia decreased hepatic I/R injury, however had no protective effect on ileal injury. We determined that Methylprednisolone and BN 52021 decreased both hepatic I/R and ileal injury due to splanchnic congestion.
Keywords: HEPATIC ISCHEMIA/REPERFUSION INJURY, TOPICAL HYPOTHERMIA, STEROIDS, PAF ANTOGONIST