Histopathological Evaluation on the Effects of Venesection and Vitamin C on Systemic Renal and Hepatic Lesions after Limb Ischemia-Reperfusion in Rabbit

Objective- To evaluate the effects of venesection and vitamin C on systemic renal and hepatic lesions after limb ischemia-reperfusion in rabbit. Design- Experimental study. Animals- 20 male white New Zealand rabbits between 2.5-3 kg, randomly assigned in 5 equal groups. Procedures- After general anesthesia right femoral artery and vein were approached from inguinal region. In treatment and control groups the ischemia was induced by occlusion of both vessels for six hours, using a Rumel tourniquet. The same procedures were performed for sham groups, except the occluding of the vessels. In treatment1 and sham1 groups, 500 mg/kg vitamin C was injected intramuscularly during 30 min before occluding of the vessels and before the end of the operation, respectively. The same volume of normal saline was injected in control and sham 2 groups. For animals in the treatment 2 group, at the end of the ischemic period, the arterial tourniquet was released to allow arterial inflow before commencement of venous aspiration. The venous blood was  aspirated into a syringe (0.5% of the animals, body weight). After 72 hours, the animals were sacrificed and tissue samples were harvested from the kidney and the liver, to assess for histological evidence of injury in these organs. Results- Limb I/R injury resulted in glomerular and epithelial alterations in the kidney, and also necrosis, capillarization, biliary hyperplasia, thrombosis and hemorrhage in the liver. Minimal microscopic renal and hepatic changes were seen in ischemic rats which treated by vitamin C. Conclusion and Clinical Relevance- This study showed that venesection was not successful in preventing kidney and liver from destruction. However, vitamin C therapy protected both organs against acute and lethal lesions due to limb I/R injury.