Original Article

Pediatric Surgery International

, Volume 27, Issue 8, pp 857-862

First online:

Ischemic preconditioning and remote ischemic preconditioning have protective effect against cold ischemia–reperfusion injury of rat small intestine

  • Isamu SaekiAffiliated withKyushu University Email author 
  • , Toshiharu MatsuuraAffiliated withKyushu University
  • , Makoto HayashidaAffiliated withKyushu University
  • , Tomoaki TaguchiAffiliated withKyushu University

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To investigate the protective effect of ischemic preconditioning (IPC) and remote ischemic preconditioning (RIPC) against cold ischemia–reperfusion injury (IRI) associated with small bowel transplantation (SBT).


Male Lewis rats weighing 200–300 g were used for this study. The rats were assigned to three groups: control, ischemic preconditioning (IPC), or remote ischemic preconditioning (RIPC). Heterotopic SBT was thereafter performed. The recipient rats were killed 3, 6, 12 and 24 h after transplantation. Specimens from the intestine were histologically scored according to a grading system (Park et al.). Serum lactate dehydrogenase (LDH), aspirate aminotransferase (AST), alanine aminotransferase (ALT) were examined and heme oxygenase-1 (HO-1) were analyzed by ELISA where HO-1 served as an indicator of protection against IRI.


The values of tissue injury were significantly lower in the IPC and RIPC groups than in control group at 3 h after SBT. The serum LDH, AST and ALT levels also significantly decreased in the IPC and RIPC groups at 3 h after SBT, but these protective effects against cold IRI diminished by 12 and 24 h after SBT. The serum HO-1 level significantly increased in the IPC and RIPC groups 3 h after SBT.


Both IPC and RIPC were found to ameliorate ischemia–reperfusion injury after rat SBT in the early phase. HO-1 may therefore play a protective role against cold IRI.


Ischemic preconditioning Remote ischemic preconditioning Intestine Small bowel transplantation Ischemia–reperfusion injury HO-1