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

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.