Waqas Farooqui1, Hans Christian Pommergaard2, Allan Rasmussen2. 1. Department of Surgery, Nordsjællands Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark. Electronic address: wf@regionsjaelland.dk. 2. Department of Surgical Gastroenterology and Transplantation, Abdominal Centre, Rigshospitalet, Blegdamsvej 9, 2100 Købehnavn Ø, Denmark.
Abstract
BACKGROUND: Solid organ transplantation is an accepted treatment for end-stage solid organ diseases. During the procedure, ischemia and reperfusion injury may affect graft and patient outcomes. Remote ischemic preconditioning (rIC) has been shown to reduce ischemia and reperfusion injury and can be performed safely. Thus, rIC may potentially improve outcomes after solid organ transplantation. Traditionally, the focus of rIC has been on the donor. However, preconditioning the recipient may be a more suitable approach in transplant settings. The current review analyzed previously published studies where rIC was performed on transplant recipients. METHODS: PubMed and EMBASE databases were searched for eligible clinical and animal studies evaluating rIC of recipients. Articles were analyzed and compared qualitatively. Risk of bias was assessed using the Cochrane Collaboration's tool for interventional clinical studies and SYRCLEs risk of bias tool for animal studies. RESULTS: A total of 12 studies were included. Overall, these studies were heterogeneous due to differences in populations and intervention set-up. Some of the studies suggested improvement of graft function, while other studies did not show any effect. The quality of the 12 included studies was predominantly low. CONCLUSION: Due to the heterogeneity and quality of the included studies the result, that rIC may be beneficial in transplantation of some organs, should be interpreted with caution. The result must be confirmed by further clinical studies.
BACKGROUND: Solid organ transplantation is an accepted treatment for end-stage solid organ diseases. During the procedure, ischemia and reperfusion injury may affect graft and patient outcomes. Remote ischemic preconditioning (rIC) has been shown to reduce ischemia and reperfusion injury and can be performed safely. Thus, rIC may potentially improve outcomes after solid organ transplantation. Traditionally, the focus of rIC has been on the donor. However, preconditioning the recipient may be a more suitable approach in transplant settings. The current review analyzed previously published studies where rIC was performed on transplant recipients. METHODS: PubMed and EMBASE databases were searched for eligible clinical and animal studies evaluating rIC of recipients. Articles were analyzed and compared qualitatively. Risk of bias was assessed using the Cochrane Collaboration's tool for interventional clinical studies and SYRCLEs risk of bias tool for animal studies. RESULTS: A total of 12 studies were included. Overall, these studies were heterogeneous due to differences in populations and intervention set-up. Some of the studies suggested improvement of graft function, while other studies did not show any effect. The quality of the 12 included studies was predominantly low. CONCLUSION: Due to the heterogeneity and quality of the included studies the result, that rIC may be beneficial in transplantation of some organs, should be interpreted with caution. The result must be confirmed by further clinical studies.
Authors: Marie B Nielsen; Kristian Ravlo; Marco Eijken; Nicoline V Krogstrup; Morten Bue Svendsen; Chadi Abdel-Halim; Mikkel Steen Petersen; Henrik Birn; Mihai Oltean; Bente Jespersen; Bjarne K Møller Journal: Clin Exp Immunol Date: 2021-09-29 Impact factor: 4.330