Impact of Ischemic Preconditioning on Outcome in Clinical Liver Surgery: A Systematic Review

Table 2

Summary of outcome in randomized controlled trials of ischemic preconditioning in orthotopic liver transplantation.

Author	Year	Donor type	IPC	No IPC	Duration of IPC (mins)	Mean ischemic time (mins)	Outcome measures	Effect of IPC
Koneru et al. [37]	2007	DBD^1	50	51	10 + up to 39	410	AR, Bili, GS, Histo, HS, INR, IPF, LFT, PNF, PS, transfusion	↑ALT/AST,; ↓moderate-severe AR (NS)
Jassem et al. [39]	2009	DBD	19	16	10 + 27–34	580	AR, AST, Bili, INR	↓AST
Franchello et al. [38]	2009	DBD	30	45	10 + 30	518	AR, Bili, GS, Histo, HS, INR, LFT, PNF	↓Hepatocyte swelling
Cescon et al. [35]	2006	DBD^2	23	24	10 + 15	385	Bili, GS, IPF, LFT, PNF, PS, PTA, transfusion	↓ALT/AST
Amador et al. [36]	2007	DBD	30	30	10 + 10	376	AR, Bili, GS, Histo, HS, ICU, IOBL, LFT, morbidity, PNF, PS, PT, transfusion	↓ALT/AST, ↓PNF (NS)
Koneru et al. [16]	2005	DBD	34	28	5 + on-going reperfusion	437	GS, Histo, LFT, PS, PNF, transfusion	↑ALT/AST (NS)

ALT, alanine aminotransferase; AR, acute rejection; AST, aspartate aminotransferase; Bili, bilirubin; DBD, donation after brain death; GS, graft survival; Histo, histology; HS, hospital stay; ICU, intensive care unit stay; INR, international normalized ratio; IOBL, intraoperative blood loss; IPC, ischemic preconditioning; IPF, initial poor function; LFT, liver function tests; NS, no statistically significant difference according to the author; PNF, primary nonfunction; PS, patient survival; PT, prothrombin time; PTA, prothrombin activity.
¹IPF defined as INR >3.0 and/or total Bili >15 mg% in absence of biliary obstruction.
²IPF defined as minimal PTA <30% normal level and/or maximum Bili >15 mg/dL in absence of hemolysis or biliary obstruction.