%0 Journal Article
%T Desferrioxamine Attenuates Pancreatic Injury after Major Hepatectomy under Vascular Control of the Liver: Experimental Study in Pigs
%A Panagiotis Varsos
%A Constantinos Nastos
%A Nikolaos Papoutsidakis
%A Konstantinos Kalimeris
%A George Defterevos
%A Tzortzis Nomikos
%A Agathi Pafiti
%A George Fragulidis
%A Emmanuel Economou
%A Georgia Kostopanagiotou
%A Vassilios Smyrniotis
%A Nikolaos Arkadopoulos
%J HPB Surgery
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/714672
%X Introduction. Pancreatic injury can manifest after major hepatectomy under vascular control. The main mechanism involved seems to be remote oxidative injury due to ¡°spillage¡± of reactive oxygen species and cytokines from the liver. The aim of this study is to evaluate the role of desferrioxamine in the prevention of pancreatic injury following major hepatectomy. Methods. Twelve Landrace pigs were subjected to a combination of major hepatectomy (70¨C75%), using the Pringle maneuver for 150 minutes, after constructing a porta-caval side-to-side anastomosis. The duration of reperfusion was 24 hours. Animals were randomly divided into a control group ( ) and a desferrioxamine group (DFX, ). DFX animals were treated with continuous IV infusion of desferrioxamine 100£¿mg/kg. Pancreatic tissue injury, c-peptide and amylase concentrations, and pancreatic tissue oxidative markers were evaluated. Results. Desferrioxamine-treated animals showed decreased c-peptide levels, decreased acinar cell necrosis, and decreased tissue malondialdehyde levels 24 hours after reperfusion compared with the control group. There was no difference in portal pressure or serum amylase levels between the groups. Conclusions. Desferrioxamine seems to attenuate pancreatic injury after major hepatectomy under vascular control possibly by preventing and reversing production and circulation of oxidative products. 1. Introduction Ischemia and reperfusion injury takes place during major hepatectomies due to the need for the use of vascular control techniques, as well as in liver transplantation and liver trauma. Although such maneuvers are invaluable in preventing excessive blood loss, they result in the production of cytokines and reactive oxygen species (ROS), which are responsible for induction of oxidative stress to the liver as well as to distant organs [1, 2]. Spillage of cytokines and inflammatory mediators has been shown to promote remote injury [3]. Hyperamylasemia and pancreatic injury has been well documented following major liver resections in patients with or without chronic liver disease [4, 5], as well as in experimental models [6]. Portal congestion, liver failure, and remote oxidative stress have been proposed as pathophysiologic mechanisms [3, 7]. Similar finding have been reported after liver transplantation [8, 9]. Although most often pancreatic injury can be subclinical, it can manifest as severe pancreatitis resulting in multiple organ failure, increasing morbidity and mortality following liver surgery [9, 10]. Desferrioxamine has been used in the past as an antioxidant in
%U http://www.hindawi.com/journals/hpb/2012/714672/