Effects of remote ischemic preconditioning on the prognosis of biliary atresia child patients receiving living donor liver transplantation

Objective To evaluate the effects of remote ischemic preconditioning (RIPC) on the ischemia/reperfusion injury (I/RI) and early outcome of biliary atresia (BA) child patients receiving living donor liver transplantation. Methods Ninety BA child patients receiving living donor liver transplantation were randomly divided into two groups (n=45): a control group and an RIPC group. Before surgery, patients in the RIPC group were tied with tourniquets at the right lower extremity before inflation to 150 mmHg (1 mmHg=0.133 kPa) for 5 min, followed by deflation over 5 min for re-infusion of the leg. The cycle was repeated three times. Then, their levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) before surgery and 2 h, 1 day and 3 days after surgery were examined. Moreover, their intensive care unit(ICU) stay, total hospitalization stay, the percentage of re-transplantation, and the mortality within one year were recorded. Results No differences were found between the two groups in ALT and AST levels before surgery and 2 h, 1 day and 3 days after surgery. There was also no statistical difference between the two groups in the incidence of main complication after surgery. Compared with the control group, the RIPC group presented decreases in ICU stay and total hospitalization stay without statistical differences (P>0.05). No statistical differences were found in the mortality of one year after surgery between the two groups. Conclusions The current study does not demonstrate the protective effects of RIPC on BA child patients receiving liver transplantation. Extended follow-up visits, an increased number of evaluation indicators and alternation of RIPC parameters will be useful to determine the clinical efficacy of RIPC in BA child patients during liver transplantation. Key words: Biliary atresia; Liver transplantation; Remote ischemic preconditioning; Ischemia/reperfusion injury