Effect of dexmedetomidine on hepatic ischemia-reperfusion injury in the setting of adult living donor liver transplantation

Autor:	Eman I. Sayed, Ashraf Elfert, Nermen A. Ehsan, Nirmeen A. Fayed, S. Saleh
Rok vydání:	2016
Předmět:	Adult Graft Rejection Male Bilirubin medicine.medical_treatment Biopsy Liver transplantation Protective Agents 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Postoperative Complications Liver Function Tests 030202 anesthesiology Risk Factors medicine Living Donors Humans Prospective Studies Dexmedetomidine Transplantation medicine.diagnostic_test business.industry Liver Diseases Graft Survival 030208 emergency & critical care medicine Analgesics Non-Narcotic Middle Aged medicine.disease Prognosis Liver Transplantation Blood pressure chemistry Liver biopsy Anesthesia Case-Control Studies Reperfusion Injury Female Liver function tests business Reperfusion injury medicine.drug Follow-Up Studies
Zdroj:	Clinical transplantation. 30(4)
ISSN:	1399-0012
Popis:	Objective The aim of this study was to investigate the hypothesis that intraoperative infusion of dexmedetomidine can exert a protective effect against hepatic ischemia-reperfusion injury (IRI) in adult living donor liver transplantation (LDLiver transplantation). Patients and methods Forty recipients were allocated into: control group (group I; n = 20) that received a placebo; and dexmedetomidine group (group II; n = 20) that received a continuous intraoperative infusion of 0.8 μg/kg/h of dexmedetomidine. Data collected were AST, ALT, bilirubin, INR, and lactate, at baseline, immediately post-operatively, and on post-operative days 1, 3, and 5. Intercellular adhesion molecule-1 (ICAM-1) was measured at: baseline, 2 and 6 h after reperfusion, and on post-operative day 1. At the end of the surgery, a liver biopsy was sent for histopathological assessment. Results No significant difference was noticed in either group regarding MELD score, baseline AST, ALT, bilirubin, INR, or lactate. Dexmedetomidine tended to decrease blood pressure and heart rate, but the comparison was insignificant. Group II showed significantly attenuated levels of ICAM-1 and significantly minimal histopathological changes. The laboratory changes showed significantly lower AST, ALT, bilirubin, INR, and lactate in group II. Conclusions Dexmedetomidine exerted protective effects against hepatic IRI during adult LDLiver transplantation, as indicated by suppression of ICAM-1, better scores of histopathological assessment, and augmented post-operative liver function tests.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b011cfeabe7446d64a690817e2d8ad96 https://pubmed.ncbi.nlm.nih.gov/26856320 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.