Format

Send to

Choose Destination
Clin Transplant. 2016 Apr;30(4):470-82. doi: 10.1111/ctr.12713. Epub 2016 Mar 3.

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

Author information

1
Anesthesia and Intensive Care, National Liver Institute, Menoufia University, ShebeenAlkoom, Menoufia, Egypt.
2
Hepatobiliary Surgery, National Liver Institute, Menoufia University, ShebeenAlkoom, Menoufia, Egypt.
3
Pathology, National Liver Institute, Menoufia University, ShebeenAlkoom, Menoufia, Egypt.
4
Clinical Biochemistry, National Liver Institute, Menoufia University, ShebeenAlkoom, Menoufia, Egypt.

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.

KEYWORDS:

ICAM-1; dexmedetomidine; ischemia-reperfusion; liver biopsy; liver transplant

PMID:
26856320
DOI:
10.1111/ctr.12713
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center