Reduktion des Ischämie/Reperfusionsschadens nach warmer Leber Ischämie am Menschen durch alpha Liponsäure Reduction of ischemia/reperfusion injury after warm liver ischemia in humans by lipoic acid

Aim of the study was to examine the protective effect of preconditioning by lipoic acid undergoing hepatic resection under inflow occlusion of the liver in humans. Twenty-four patients undergoing liver resection for various reasons alternatively received 600 mg (50 ml) lipoic acid or 50 ml aqua bidest. 15 minutes before transection performed under inflow occlusion (30 minutes) of the liver. Blood samples and liver wedge biopsy samples were obtained after opening of the abdomen, immediately after inflow occlusion of the liver and 30 minutes after the end of inflow occlusion of the liver. Serum levels of aspartate transferase and alanine transferase were reduced under treatment by lipoic acid versus controls. Electron microscopy confirmed no features of necrosis in untreated and treated patients. TUNEL-staining of liver sections demonstrated a decrease of apoptotic sinusoidal lining cells and hepatocytes in the LA-group. Lipoic acid preconditioning seems to be a simple and effective method protecting the liver against prolonged periods of ischemia. Decreasion of apoptotic cell injury could be one of the mechanisms of action of lipoic acid. Einleitung