摘要
Objective To investigate the efficacy of ursodeoxycholic acid in treatment of ischemia-reperfusion injury （IRI） in liver transplantation. Methods Eighty liver transplantation adult recipients were preoperatively enrolled and randomized into the ursodeoxycholic acid （ UDCA ） （42 cases） and control （ 38 cases ） groups between May 2005 and June 2006. The two groups were statistically compared in liver biochemical parameters on post- transplant d 1, 7, 14, and 21. Rates of severe IRI-induced liver graft dysfunction, acute cellular rejection （ ACR ） episode, drug-induced hepatotoxicity, viral hepatitis, and recurrence of primary liver disease were measured within 3 weeks post-transplantation; and rates of vascular, biliary complications, and death were also measured within 3 months post-transplantation. Results In the UDCA group, serum levels of alanine aminotransferase （ ALT） on post-transplant d 7, 14, and 21 were significantly lower than those in the control group （ P = 0. 002,0. 030, 0. 049, respectively）. Compared with the control group, serum levels of aspartate aminotransferase （ AST） and y-Glutamyltranspeptidase （ GGT） on d 7 were also lower in the UDCA group （ P =0. 012 and 0. 025）. The cases of severe IRI- induced liver graft dysfunction in the UDCA group were significantly fewer than those in the control group （ 17. 5% vs. 26.3%, P =0. 048）. There were no significant differences in rates of ACR episode, histological Banff grading, or drug-induced hepatotoxicity within 3 weeks post-transplantation as well as rates of vascular, biliary complications, and death within 3 months post-transplantation between the two groups. We did not find any case of viral hepatitis or recurrence of primary liver disease in the study. Conclusion UDCA treatment can improve graft IRI early after liver transplantation. It significantly decreased serum ALT level and incidence of severe IRl-induced liver dysfunction within post-transplant 3 weeks. Cytoprection of hepatocytes by UDCA was more outstanding than that of bile duct when cold ischemia time was beneath 12 h. Vascular and biliary complications within 3 months post-transplantation can not be affected by UDCA administration in the study.
Objective To investigate the efficacy of ursodeoxycholic acid in treatment of ischemia-reperfusion injury (IRI) in liver transplantation. Methods Eighty liver transplantation adult recipients were preoperatively enrolled and randomized into the ursodeoxycholic acid (UDCA) (42 cases) and control (38 cases) groups between May 2005 and June 2006. The two groups were statistically compared in liver biochemical parameters on post-transplant d 1, 7, 14, and 21. Rates of severe IRI-induced liver graft dysfunction, acute cellular rejection (ACR) episode, drug-induced hepatotoxicity, viral hepatitis, and recurrence of primary liver disease were measured within 3 weeks post-transplantation; and rates of vascular, biliary complications, and death were also measured within 3 months post-transplantation. Results In the UDCA group, serum levels of alanine aminotransferase (ALT) on post-transplant d 7, 14, and 21 were significantly lower than those in the control group (P=0.002, 0.030, 0.049, respectively). Compared with the control group, serum levels of aspartate aminotransferase (AST) and γ-Glutamyl-transpeptidase (GGT) on d 7 were also lower in the UDCA group (P=0.012 and 0.025). The cases of severe IRI-induced liver graft dysfunction in the UDCA group were significantly fewer than those in the control group (17.5% vs. 26.3%, P=0.048). There were no significant differences in rates of ACR episode, histological Banff grading, or drug-induced hepatotoxicity within 3 weeks post-transplantation as well as rates of vascular, biliary complications, and death within 3 months post-transplantation between the two groups. We did not find any case of viral hepatitis or recurrence of primary liver disease in the study. Conclusion UDCA treatment can improve graft IRI early after liver transplantation. It significantly decreased serum ALT level and incidence of severe IRI-induced liver dysfunction within post-transplant 3 weeks. Cytoprection of hepatocytes by UDCA was more outstanding than that of bile duct when cold ischemia time was beneath 12h. Vascular and biliary complications within 3 months post-transplantation can not be affected by UDCA administration in the study.
