Tesis

Evaluasi Histopatologis Cedera Remote Iskemik Reperfusi Organ Hepar Kelinci Yang Dilakukan Prekondisi Iskemik Dan Hipotermia = Histopatologic Evaluation On Remote Ischemic Reperfusion Injury Of Rabbit Liver Performed Under Ischemic Precondiotioning And Hypothermia

Latar Belakang: Cedera iskemik reperfusi merupakan suatu kondisi yg sering
dijumpai, dan dapat menyebabkan gangguan secara sitemik pada organ tubuh.
Antara lain dapat menyebabkan kerusakan ke jaringan hepar secara remote.
Tujuan: Mengetahui manfaat perlakuan prekondisi iskemik dan hipotermia pada
cedera iskemik reperfusi tungkai bawah guna mencegah terjadinya kerusakan
pada jaringan hepar
Metode. Dilakukan penelitian eksperimental pada kelinci New Zealand White
(n=18) dengan satu kelompok kontrol (iskemia) dan dua kelompok perlakuan
(hipotermia dan prekondisi iskemik). Dilakukan ligasi a. iliaca communis
selama 4 jam, hipotermia (28
o
C), dan prekondisi iskemia pada masing-masing
kelompok. Kemudian ligasi dilepas untuk reperfusi selama 8 jam. Lalu kelinci di
euthanasia, jaringan hepar diambil untuk pemeriksaan histopatologi (Skoring
penelitian).
Hasil: Terdapat kerusakan jaringan hepar yang dinilai secara histopatologi
sebagai efek cedera iskemik reperfusi jauh yang di akibatkan oleh iskemik
tungkai akut pada hewan coba kelinci. Dengan melakukan skoring terhadap sel
hepatosit, sitoplasma, sinusoid, batas interselular, mikrohemoragik, dan infiltrasi
leukosit. Skor kelompok kontrol dengan median 89,50 min-max 75-91,
Kelompok perlakuan IPC mean 49,17, SD 15,53. Kelompok perlakuan
hipotermia mean 42,83 SD 22,02. Prekondisi iskemik dan hipotermia dapat
mengurangi terjadi kerusakan jauh pada hepar secara bermakna dengan nilai
p=0,002 dan p=0,004
Simpulan: Terbukti terjadinya kerusakan remote iskemik reperfusi pada hepar
akibat cedera iskemik reperfusi tungkai akut, Hipotermia dan iskemik prekondisi
secara signifikan dapat mengurangi terjadinya kerusakan itu.


Background: ischemic reperfusion injury is a common condition that may disrupt
systemic organs, especially causing liver damage remotely.
Objectives: to evaluate the benefit of ischemic preconditioning and hypothermia
on ischemic reperfusion injury of the lower limbs from liver tissue damage.
Methods: this experimental study was performed using New Zealand White
Rabbits (n=18) that were grouped into control group (ischemia) and treatment
group (ischemic preconditioning and hypothermia). Iliaca communis artery was
ligated for 4 hours and treated group had topical cooling until 28
C and
performed ischmeic preconditioning. The ligation was released for reperfusion
for 8 hours. The rabbits were then euthanized and liver tissue was taken for
histopathologic examination.
Result: liver tissue damage was found histopathologically caused by remote
ischemic reperfusion of rabbit limbs. By performing scoring of hepatocyte cells,
cytoplasm, sinusioids, intercellular cells, microhemorrhage, and leucocyte
infiltration. The median score for control group was 89.50 (ranged 75-91), and
49.17 for IPC group (SD 15.53).mean score for hypothermia group is 42.83 (SD
22.02). IPC and hypothermia showed to reduce liver damage significantly (p =
0.002 and p = 0.004).
Conclusion: it has proven that liver damage occurs in remote ischemic
reperfusion injury of limbs and iscemic preconditioning and hypothermia have
reduce the damage.