Postconditioning: current controversies and clinical implications.

Abstract

Postconditioning of ischaemic tissue, via mechanical or pharmacological manipulation, offers an exciting avenue towards amelioration of ischaemia-reperfusion injury. Born from the concept of ischaemic preconditioning, postconditioning is advantageous in that prior knowledge of the ischaemic insult is not required, and thus clinical translation may be further reaching. This review explores the current evidence and controversies in both animal and human studies and multiple organ systems. A Medline search was conducted to identify English-language articles with 'postconditioning' as a keyword. Two independent researchers scrutinised the literature search for potentially relevant articles. Reference lists from selected articles were manually searched for further relevant articles. Postconditioning has been shown to be successful in reducing ischaemia-reperfusion injury in both animal models and clinical trials. Human studies are presently limited to cardiac studies, but there is scope for research into other organ systems with potential beneficial effects, particularly within the field of vascular surgery where ischaemia-reperfusion occurs by nature of both - the disease and the intervention.