Abstract:

BACKGROUND: Ischemia/reperfusion injury is one of main reasons of thrombosis and acute pancreatitis following pancreatic transplantation, and is the unavoidable process of pancreatic transplantation, finally results in affecting the function of transplanted pancreas. How to relieve ischemia/reperfusion injury is a hot point of transplantation surgery at present.
OBJECTIVE: To evaluate the protective effects of different ways of ischemic postconditioning on ischemia/reperfusion injury in rat pancreas after transplantation.
METHODS: A total of 48 diabetic Sprague Dawley rats were randomly assigned to four groups: control group (C，n=12), ischemic postconditioning 1 group (30-second reperfusion followed by 30-second ischemia once), ischemic postconditioning 2 group (30-second reperfusion followed by 30-second ischemia thrice), and ischemic postconditioning 3 group (30-second reperfusion followed by 30-second ischemia six times). All groups received pancreas transplantation. A total of 48 healthy Sprague Dawley rats served as donors. The blood glucose pre- and post-reperfusion, malondialdehyde (MDA), superoxide dismutase (SOD) and myeloperoxidase (MPO) changes at 2 hours postreperfusion were detected in the pancreatic tissue in each group. Apoptotic cells in graft were monitored by TUNEL assay.
RESULTS AND CONCLUSION: Glucose levels were decreased in the ischemic postconditioning groups compared with control group following ischemia/reperfusion group (P < 0.01). Glucose levels were lower in the ischemic postconditioning 2 group compared with ischemic postconditioning 1 group and ischemic postconditioning 3 group (P < 0.05). The SOD levels were greater (P < 0.01), but MDA and MPO levels were lower (P < 0.01) in the ischemic postconditioning groups compared with control group following ischemia/reperfusion. SOD levels were greater (P < 0.05), but MDA and MPO levels were lower (P < 0.05) in the ischemic postconditioning 2 group compared with ischemic postconditioning 1 group and ischemic postconditioning 3 group. Apoptotic index was low in the ischemic postconditioning groups compared with control group following reperfusion (P < 0.01). Apoptotic index was lower in the ischemic postconditioning 2 group compared with ischemic postconditioning 1 group and ischemic postconditioning 3 group (P < 0.05). These indicated that ischemic postconditioning can protect graft from ischemia/reperfusioin injury and reduce apoptosis of the graft during pancreas transplantation. Three cycles of 30-seconds ischemia and 30-seconds reperfusion are the best way to induce ischemic preconditioning in rat pancreas transplantation.