Cytokine Changes during Warm Ischemia and Reperfusion of the Pig Liver with or without Preconditioning

Abstract

Background: Hepatic inflow occlusion results in ischemia-reperfusion injury. The aim of the present porcine study was to investigate whether the pro- and anti-inflammatory cytokine response is involved in mediating the protective effect of ischemic preconditioning (IPC) during, and after warm liver ischemia. Methods: Fifteen randomized pigs – 7 non-IPC and 8 (IPC) – underwent laparotomy followed by 60 min of total ischemia with or without IPC continued by 3 h of reperfusion. Plasma cytokines (IL-6, IL-8, IL-10, and TNF-α) were measured during the study period as well as liver parameters (alanine-aminotransferase, alkaline phosphatase, bilirubin, and prothrombin time). Results: In the IPC group, IL-6 increased significantly during reperfusion compared to baseline and the non-IPC group. TNF-α increased nonsignificantly in the non-IPC group, while the levels remained stable in the IPC group. IL-8 and IL-10 increased in both groups after reperfusion. Only minor differences were observed in liver parameters. Conclusions: Warm liver ischemia with or without IPC activates inflammatory cytokines. IL-6 increased significantly in the IPC group compared to the non-IPC group, while the opposite was observed for TNF-α. These cytokine changes may be involved in the hepatoprotective mechanism induced by IPC.