Exosome is involved in liver graft protection after remote ischemia reperfusion conditioning

Background: Remote ischemic perconditioning（RIPer C） has been demonstrated to protect grafts from hepatic ischemia-reperfusion injury（IRI）. This study investigated the role of exosomes in RIPer C of liver grafts in rats. Methods: Twenty-five rats（including 10 donors） were randomly divided into five groups（ n = 5 each group）: five rats were used as sham-operated controls（Sham）, ten rats were for orthotopic liver transplantation（OLT, 5 donors and 5 recipients） and ten rats were for OLT + RIPer C（5 donors and 5 recipients）. Liver architecture and function were evaluated. Results: Compared to the OLT group, the OLT + RIPer C group exhibited significantly improved liver graft histopathology and liver function（ P ＜ 0.05）. Furthermore, the number of exosomes and the level of P-Akt were increased in the OLT + RIPer C group. Conclusions: RIPer C effectively improves graft architecture and function, and this protective effect may be related to the increased number of exosomes. The upregulation of P-Akt may be involved in underlying mechanisms.