Optimized postconditioning algorithm protects liver graft after liver transplantation in rats.

Area of Science:

• Hepatology
• Transplantation Surgery
• Cellular and Molecular Biology

Background:

• Ischemia reperfusion injury (IRI) is a major cause of complications in liver surgery and transplantation.
• Postconditioning (PostC) is a protective strategy against hepatic IRI.
• Optimizing PostC protocols is crucial for improving patient outcomes.

Purpose of the Study:

• To optimize postconditioning (PostC) protocols for reducing hepatic ischemia reperfusion injury (IRI).
• To investigate the underlying protective mechanisms of optimized PostC in a rat liver transplantation model.

Main Methods:

• Rats underwent orthotopic liver transplantation (OLT) and were divided into sham, OLT, and PostC groups.
• The PostC group received varying time-interval stimuli (e.g., 10s x 3, 10s x 6 cycles).
• Evaluated liver function, histopathology, oxidative stress markers (MDA), neutrophil infiltration (MPO), and gene expression (p-Akt, ERS).

Main Results:

• The 10s x 6 cycles PostC protocol significantly improved liver graft function and morphology compared to OLT alone.
• PostC markedly reduced malondialdehyde (MDA) and myeloperoxidase (MPO) levels.
• Endoplasmic reticulum stress (ERS) genes were downregulated, while p-Akt expression was upregulated by PostC.

Conclusions:

• The 10s x 6 cycles PostC protocol is effective in mitigating rat liver graft IRI.
• Protective effects are linked to antioxidant properties, ERS inhibition, and p-Akt pathway activation.
• This optimized PostC strategy holds promise for clinical application in liver transplantation.