Prostaglandin E1 administration post liver transplantation and renal outcomes:A retrospective single center experience  

作　　者：Vinay Jahagirdar Mohamed Ahmed Ifrah Fatima Hassam Ali Laura Alba John H Helzberg Lee S Cummings Matthew Wilkinson Jameson Forster Alisa Likhitsup 

机构地区：[1]Department of Internal Medicine,Saint Luke’s Health System of Kansas City and the University of Missouri-Kansas City,Kansas City,MO 64111,United States [2]Department of Gastroenterology and Hepatology,East Carolina University Brody School of Medicine,Greenville,NC 27834,United States [3]Division of Internal Medicine,Department of Gastroenterology and Hepatology,Saint Luke’s Health System of Kansas City and University of Missouri-Kansas City,Kansas City,MO 64111,United States [4]Department of Surgery,University of Missouri-Kansas City and Transplant Surgery,Saint Luke’s Hospital of Kansas City,Kansas City,MO 64111,United States [5]Department of Gastroenterology and Hepatology,University of Michigan,Ann Arbor,MI 48109,United States

出　　处：《World Journal of Transplantation》2024年第4期101-109,共9页世界移植杂志

摘　　要：BACKGROUND Prostaglandin E1(PGE1),or alprostadil,is a potent vasodilator that improves hepatic blood flow and reduces ischemia-reperfusion injury post-liver transplantation(LT).However,the benefits of PGE1 on renal function after LT have not yet been well described.AIM To assess the impact of PGE1 administration on renal function in patients who underwent liver or liver-kidney transplant.METHODS This retrospective study included all patients who underwent liver or liverkidney transplant at our institution from January,2011 to December,2021.Patients were classified based on whether they received PGE1.PGE1 was administered post-LT to those with transaminases>1000 U/L in the immediate postoperative period.Demographics,post-LT treatments and/or complications,renal function,and survival were analyzed.Multivariable logistic regression analysis was performed,and a two-tailed P value<0.05 was considered statistically significant.RESULTS A total of 145 patients underwent LT,with 44(30%)receiving PGE1.Baseline patient characteristics were comparable,except the PGE1 group had significantly higher aspartate aminotransferase(AST)(1961.9 U/L±1862.3 U/L vs 878 U/L±741.4 U/L,P=0.000),alanine aminotransferase(1070.6 U/L±895 U/L vs 547.7 U/L±410 U/L,P=0.000),international normalized ratio on post-LT day 1(2±0.74 vs 1.8±0.4,P=0.03),a longer intensive care unit stay(8.1 days±11.8 days vs 3.8 days±4.6 days,P=0.003),more vasopressor use(55.53 hours±111 hours vs 16.33 hours±26.3 hours,P=0.002),and higher immediate postoperative complications(18.6%vs 4.9%,P=0.04).The PGE1 group also had a significantly higher 90-day readmission rate(29.6%vs 13.1%,P=0.02)and lower 1-year liver graft survival(87.5%vs 98.9%,P=0.005).However,30-day readmission(31.6%vs 27.4%,P=0.64),LT complications(hepatic artery thrombosis,biliary complications,rejection of liver graft,cardiomyopathy),1-year patient survival(96.9%vs 97.8%,P=0.77),overall liver graft survival,and overall patient survival were similar between the two groups(95.4%vs 93.9%,P=0.74 and

关 键 词：Liver transplantation ALPROSTADIL Protective agents TRANSPLANT Prostaglandin E1 

分 类 号：R657.3[医药卫生—外科学]