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World J Gastrointest Surg. Feb 27, 2026; 18(2): 114997
Published online Feb 27, 2026. doi: 10.4240/wjgs.v18.i2.114997
Published online Feb 27, 2026. doi: 10.4240/wjgs.v18.i2.114997
Protective effect of ischemic preconditioning against hepatic ischemia-reperfusion injury and associated remote organ damage
Christina Mouratidou, Serafeim-Chrysovalantis Kotoulas, Alexandra G Marneri, Eleni Massa, Intensive Care Unit, Hippokration General Hospital, Thessaloniki 54642, Greece
Efstathios T Pavlidis, Ioannis N Galanis, Theodoros E Pavlidis, The Second Department of Propaedeutic Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece
Georgios Katsanos, Athanasios Kofinas, Georgios Tsoulfas, Department of Transplantation Surgery, Center for Research and Innovation in Solid Organ Transplantation, Aristotle University of Thessaloniki, School of Medicine, Thessaloniki 54642, Greece
Co-corresponding authors: Efstathios T Pavlidis and Theodoros E Pavlidis.
Author contributions: Mouratidou C, Pavlidis ET, and Massa E conceived the study design and carried out data analysis; Kotoulas SC, Marneri AG, and Tsoulfas G developed analytical tools, assessed the data, and contributed to manuscript revision; Katsanos G, Kofinas A, and Galanis IN assisted with data collection and interpretation; Pavlidis TE supervised data analysis, reviewed the manuscript, and approved the paper.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Theodoros E Pavlidis, MD, PhD, Professor Emeritus, The Second Department of Propaedeutic Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, Konstantinoupoleos 49, Thessaloniki 54642, Greece. pavlidth@auth.gr
Received: October 9, 2025
Revised: November 6, 2025
Accepted: December 5, 2025
Published online: February 27, 2026
Processing time: 145 Days and 2.6 Hours
Revised: November 6, 2025
Accepted: December 5, 2025
Published online: February 27, 2026
Processing time: 145 Days and 2.6 Hours
Core Tip
Core Tip: Hepatic ischemia-reperfusion injury remains a critical challenge in liver surgery and transplantation and results in increased postoperative morbidity and mortality. The complexity of the underlying pathophysiological mechanisms makes liver damage difficult to manage. Ischemic preconditioning is a promising protective strategy that limits hepatic injury while providing systemic benefits through the regulation of oxidative stress, the inflammatory response, and programmed cell death pathways. By offering protection to remote organs, ischemic preconditioning has the potential to enhance the out