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

Abstract:

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.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Fayed NA,Sayed EI,Saleh SM,Ehsan NA,Elfert AY

doi

10.1111/ctr.12713

subject

Has Abstract

pub_date

2016-04-01 00:00:00

pages

470-82

issue

4

eissn

0902-0063

issn

1399-0012

journal_volume

30

pub_type

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