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The Effect of Pringle Maneuver Applied during Living Donor Hepatectomy on the Ischemia-Reperfusion Injury Observed in the Donors and Recipients

  • 0Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, 44280 Malatya, Turkey.
Medicina +

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April 27, 2024

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April 27, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

The Pringle maneuver did not increase ischemia-reperfusion injury in liver donors or recipients, despite causing higher hepatocyte damage in donors. This study evaluated clinical and lab changes in liver transplantation.

Area Of Science

  • Hepatology
  • Transplantation Surgery
  • Immunology

Background

  • Ischemia-reperfusion injury (IRI) is a significant concern in liver transplantation.
  • The Pringle maneuver is used to reduce bleeding during liver surgery.
  • Its impact on IRI in living donor liver transplantation (LDLT) requires further investigation.

Purpose Of The Study

  • To evaluate clinical and laboratory markers of IRI in remnant livers of living liver donors.
  • To assess IRI in recipients receiving grafts from donors who underwent the Pringle maneuver.
  • To compare outcomes between donors and recipients with and without the Pringle maneuver.

Main Methods

  • A randomized double-blind study included 108 patients (54 donors, 54 recipients).
  • Donors and recipients were divided into Pringle maneuver applied and not applied groups.
  • Blood samples and liver tissue were analyzed for liver function, CBC, coagulation, inflammatory markers (IL-1, IL-2, IL-6, TNF-α), and histopathology.

Main Results

  • No significant differences in biochemical markers of IRI were observed in donors or recipients with or without the Pringle maneuver.
  • Perioperative bleeding and early bile duct complications did not differ significantly between recipient groups.
  • Histopathological examination revealed significantly higher hepatocyte damage in the Pringle maneuver group (p=0.001).

Conclusions

  • The Pringle maneuver did not exacerbate IRI in liver donors or recipients based on clinical and laboratory assessments.
  • Despite increased histological hepatocyte damage, the Pringle maneuver's overall impact on IRI in LDLT appears minimal.
  • Further research may explore the long-term implications of Pringle maneuver-induced histological changes.

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