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

Table 4

Summary of outcome in randomized controlled trials of ischemic preconditioning in liver resection.

Author	Year	IPC	No IPC	Duration of IPC (mins)	Mean ischemic time (mins)^1	Outcome measures	Effect of IPC
Arkadopoulos et al. [49]	2009	41	43	10 + 15	42 (TVE)	AST, Bili, HS, ICU, IOBL, PT, morbidity, transfusion	↓AST
Azoulay et al. [47]	2006	30	30	10 + 10	46 (TVE)	Bili, HS, ICU, IOBL, LFT, morbidity, PT, transfusion,	↑ALT/AST (NS),; ↓HS/ICU (NS)
Winbladh et al. [45]	2012	16	16	10 + 10	42 (IPTC)	Bili, HS, INR, IOBL, LFT, morbidity, transfusion	No difference
Scatton et al. [46]	2011	40	39	10 + 10	49 (IPTC)	ALT, Bili, HS, ICU, IOBL, morbidity, PT, transfusion,	No difference
Heizmann et al. [48]	2008	30	31	10 + 10	34	ALT, Bili, ICU, IOBL, morbidity, transfusion	↓ALT (NS) ↓IOBL, ↓postoperative complications, ↓transfusion requirement
Clavien et al. [20]	2003	50	50	10 + 10	36	Bili, HS, ICU, IOBL, morbidity, LFT, PT, transfusion	↓ALT/AST

ALT, alanine aminotransferase; AST, aspartate aminotransferase; Bili, bilirubin; HS, hospital stay; ICU, intensive care unit stay; IOBL, intraoperative blood loss; IPC, ischemic preconditioning; IPTC, intermittent portal triad clamping; LFT, liver function tests; NS, no statistically significant difference according to the author; PT, prothrombin time; TVE, total vascular exclusion.
¹Continuous Pringle maneuver unless otherwise specified.