Published online Jan 28, 2021. doi: 10.3748/wjg.v27.i4.345
Peer-review started: October 29, 2020
First decision: November 30, 2020
Revised: December 9, 2020
Accepted: December 26, 2020
Article in press: December 26, 2020
Published online: January 28, 2021
Processing time: 87 Days and 22.3 Hours
Studies suggested that remote ischemic preconditioning (RIPC) may effectively lessen the harmful effects of ischemia reperfusion injury during organ transplantation surgery.
To investigate the protective effects of RIPC on living liver donors and recipients following pediatric liver transplantation.
From January 2016 to January 2019 at Renji Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, 208 donors were recruited and randomly assigned to four groups: S-RIPC group (no intervention; n = 55), D-RIPC group (donors received RIPC; n = 51), R-RIPC group (recipients received RIPC, n = 51) and DR-RIPC group (both donors and recipients received RIPC; n = 51). We primarily evaluated postoperative liver function among donors and recipients and incidences of early allograft dysfunction, primary nonfunction and postoperative complications among recipients.
RIPC did not significantly improve alanine transaminase and aspartate aminotransferase levels among donors and recipients or decrease the incidences of early allograft dysfunction, primary nonfunction, and postoperative complications among recipients. Limited protective effects were observed, including a lower creatinine level in the D-RIPC group than in the S-RIPC group on postoperative day 0 (P < 0.05). However, no significant improvements were found in donors who received RIPC. Furthermore, RIPC had no effects on the overall survival of recipients.
The protective effects of RIPC were limited for recipients who received living liver transplantation, and no significant improvement of the prognosis was observed in recipients.
Core Tip: Ischemia reperfusion injury (IRI) has been a well-known underlying cause for inducing or aggravating primary graft nonfunction, vascular complications and biliary complications during liver transplantation (LT). Some studies suggested that remote ischemic preconditioning (RIPC) may effectively lessen the harmful effects of IRI during organ transplantation surgery. However, studies on the effect of RIPC on pediatric LT were rare. The present single-center randomized clinical trial aimed to determine whether RIPC could be beneficial for reducing IRI among both donors and recipients undergoing pediatric LT.