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Göteborgs universitets publikationer

Recipient Hyperbilirubinemia May Reduce Ischemia-Reperfusion Injury but Fails to Improve Outcome in Clinical Liver Transplantation

Författare och institution:
Mihai Oltean (Institutionen för kliniska vetenskaper); Christian Barrenäs (Institutionen för kliniska vetenskaper); P. N. Martins (-); Gustaf Herlenius (Institutionen för kliniska vetenskaper); Bengt I. Gustafsson (Institutionen för kliniska vetenskaper); Styrbjörn Friman (Institutionen för kliniska vetenskaper); William Bennet (Institutionen för kliniska vetenskaper)
Publicerad i:
Gastroenterology Research and Practice, 2016 s. Article ID 6964856
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
Background. Exogenous bilirubin may reduce experimental ischemia-reperfusion injury (IRI) due to its antioxidant properties. We studied if early graft exposure to high bilirubin levels in the recipient affects the early IRI and outcomes after liver transplantation (LTx). Methods. In 427 LTx patients, the AUROC curve based on bilirubin and AST at day 1 identified a cutoff of 2.04mg/dL for the recipient pretransplant bilirubin. Recipients were grouped as having low (group L, n = 152) or high (group H, n = 275) bilirubin. Both groups had similar donor-related variables (age, preservation time, donor BMI > 28, and donor risk index (DRI)). Results. Alanine (ALT) and aspartate (AST) aminotransferase levels were higher in group L at day 1; ALT levels remained higher at day 2 in group L. LTx from high risk donors (DRI > 2) revealed a trend towards lower transaminases during the first two days after transplantation in group H. One month and 1-year patient survival were similar in groups L and H. High preoperative bilirubin did not affect the risk for early graft dysfunction (EGD), death, or graft loss during the first year after transplantation nor the incidence of acute rejection. LTx using donors with DRI > 2 resulted in similar rates of EGD in both groups. Conclusion. Increased bilirubin appears to reduce the early IRI after LTx yet this improvement was insufficient to improve the clinical outcome.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Klinisk medicin
early allograft dysfunction, donor risk index, carbon-monoxide, heme, oxygenase-1, biliverdin reductase, ischemia/reperfusion injury, graft, failure, bilirubin, suppresses, protection, Gastroenterology & Hepatology
Postens nummer:
Posten skapad:
2016-07-05 14:13
Posten ändrad:
2016-07-06 09:29

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