OP 91. Remote Ischemic Preconditioning Decreases Renal Ischemia- Reperfusion Injury

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A Kapelouzou, D. Athanasiadis, M. Katsimboulas, G. Martikos, M. Peroulis, E. Balafas, S. Vasdekis, K. Alkiviadis, T. Liakakos, A Lazaris

Chair(s): Norbert Németh, Ivo Post & Thomas Hubert

11:10 - 11:20h at Buda Room (B)

Categories: Innovative Surgical Research, Novel Techniques and Product, Oral Session

Session: Oral Session X - Innovative Surgical Research

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Background
Temporary renal ischemia consists a significant factor that increases morbidity and mortality after thoracoabdominal aortic aneurysm (TAAA) open repair. Remote ischemic preconditioning (RIPC) has been considered a mean of decreasing ischemia/reperfusion injury (IRI) in various tissues. Aim of the study was to identify the effect of RIPC in reducing renal IRI in an animal model of TAAA open repair

Material and Methods
Twenty male swine were divided in 4 groups: Sham (control), IR, RIPC15, and RIPC3x5. All animals, except in the Sham group, underwent a 30 minutes visceral ischemia after a concomitant subphrenic and infrarenal aortic clamping followed by a 200 minutes reperfusion before the closure of the abdominal cavity. In RIPC15 group the preconditioning consisted of 15 minutes of ischemia followed by 15 minutes of reperfusion, while in RIPC3x5 group of 3 cycles of 5 minutes ischemia followed 5 minutes of reperfusion. Elective renal vein blood was retrieved from the renal vein in specific time intervals of reperfusion, ranging from 30 minutes to 24 hours post-ischemia. Using ELISA techniques, serum was examined for various parameters indicating IR injury (MDA), inflammation and renal tissue damage (CRP, TNFa, Troponin I), as well as renal function (Urea, Creatinine, Cystatin C, NGAL).

Result
All examined parameters were found to be less impaired in animals of RIPC groups compared to IR group, at a significant statistical level.

Conclusion
Blood data demonstrate a beneficial effect in reducing renal IRI induced in a way similar to the one during a TAAA open repair, when RIPC has been preceded the IRI.