Reduction of ischemia reperfusion injury after liver resection and hepatic inflow occlusion by α-lipoic acid in humans

Figure 1 Lactate (A) and cholinesterase (B) levels after laparotomy (LAP), 30 min of ischemia (pP0´), 30 min of ischemia with 30 min of reperfusion (pP30´) and 24 h after operation with and without 600 mg LA 15 min prior to ischemia, values as means ± SD, n = 12 each group, ^aP < 0. 05 vs NaCl.

Figure 2 AST (A) and ALT (B) levels after laparotomy (LAP), after 30 min of ischemia (pP0´), after 30 min of ischemia with 30 min of reperfusion (pP30´) and after d 1-3 (peak level) with and without 600 mg LA 15 min prior to ischemia, values as means ± SD, n = 12 each group, ^aP < 0. 05 vs NaCl.

Figure 3 ATP-content in liver tissue after laparotomy (LAP), after 30 min of ischemia (pP0´) and after 30 min of ischemia with 30 min of reperfusion (pP30´) with and without 600 mg LA 15 min prior to ischemia, values as means ± SD, n = 12 each group, ^aP < 0. 05 vs NaCl.

Figure 4 Representative liver sections after laparotomy (LAP), after 30 min of ischemia (pP0') and after 30 min of ischemia with 30 min of reperfusion (pP30') with and without 600 mg LA 15 min prior to ischemia, (HE×200-400). A, B: In both groups no features of cell injury after LAP; C, D: At pP0' there was a mild oncotic injury in the untreated and pretreated group such as hepatocytes swelling and vacuolization; E, F: At pP30' oncotic injury was increased especially in the untreated group (F): there were areas with focal necrosis (asterisk) and areas with eosinophilia and oncosis (arrows). In the LA pretreated group oncotic cell injury was rare (E).

Figure 5 Representative liver sections stained with TUNEL assay after 30 min of ischemia (pP0') and after 30 min of reperfusion (pP30') with and without 600 mg LA 15 min prior to ischemia. Positive control was prepared from liver-tissue samples by treating with DNase I in accordance with manufactures guidelines (E). After LAP TUNEL-positive hepatocytes were rare (data not shown). We observed TUNEL-positive hepatocytes in the untreated group at pP0' and at pP30' (B, D) while TUNEL staining was decreased in the LA pretreated group at the same time point (A, C); F: TUNEL-positive hepatocytes after laparotomy (LAP), after 30 min of ischemia (pP0') and after 30 min of reperfusion (pP30') with and without 600 mg LA 15 min prior to ischemia, values as means ± SD, n = 5 each group, ^bP < 0.01 vs vehicle (NaCl) group.