Steroid protection of the liver during experimental eschemia

Temporary occlusion of hepatic inflow would be ideal during extensive operations for liver trauma or tumors, since this always is handicapped by accompanying massive blood loss. Since the liver is relatively low in tolerance to ischemia an attempt has been made to protect the liver with steroids during experimental warm ischemia. Total hepatic ischemia was produced in rabbits by ligating the portal triad and gastrohepatic ligament for 30 minutes. A survival rate of only 10 per cent was obtained in controls, whereas if methylprednisolone was given before occlusion, 100 per cent of the rabbits survived. If methylprednisolone was given immediately after the occlusion, the survival rate was 54 per cent. Further experiments extending occlusion to one hour resulted in a 50 per cent survival rate as compared with zero per cent in the one hour controls. Methylprednisolone protects the liver during warm ischemia, especially if given before occlusion, and dramatically decreases the mortality rate from this maneuver in our model. The mechanism of protection is probably by stabilizing and protecting the integrity of the hepatic cell during the anoxic insult.