The Liver Unit of the Department of Surgery at the Milan University, Italy, published in September's issue of HPB journal a study which aimed at determining wether steroid administration may reduce liver injury and improve short term outcome.
The study included 43 patients undergoing liver resection, randomizing the groups to steroid receiving patients and a control group. Patients receiving steroids, were given 500 mg of methylprednisolone preoperatively. Levels of ALT, AST, total bilirubin, AT-III, PT, IL-6, TNF alfa were compared. Length of stay and complications were recorded.
Postoperative serum levels of ALT,AST, total bilirubin, inflammatory cytokines were lower in the steroid group. The incidence of postoperative complications in the control group tended to be higher than the steroid group.
The study concluded that steroid pretreatment represents a potentially important biologic modifier of I/R injury and may contribute to maintenance of coagulant/anticoagulant homeostasis.
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2007/10/13
Randomized Study of the Benefits of Preoperative Cosrticosteroid Administration on Hepatic I/R Injury
2007/10/07
Thymoglobulin Induction Protects Liver Allografts From Ischemia/Reperfusion Injury
The Department of Surgery of the University of Illinois, published a study in August 2005 trying to asses the ability of TG to protect against ischemia/reperfusion injury in liver transplant recipients.
Twenty two cadaveric liver transplant recipients were randomized to receive either TG (1,5 mg/kg/dose) during the anhepatic period and QOD x 2 doses, or no TG. Maintenance immunosupression consisted of Tacrolimus (or Cyclosporine) and steroids in both groups. Donor byopsies were taken during the organ procurement, cold storage, and 1 hour after re-vascularization.
Patient survival at 3 months was 100%. There was no incidence of PNF and no need for re-transplantation. The incidence of acute rejection was similar in both groups. Patients with TG had significanly decreases in alanine amino transferase and total bilirubin.
Twenty two cadaveric liver transplant recipients were randomized to receive either TG (1,5 mg/kg/dose) during the anhepatic period and QOD x 2 doses, or no TG. Maintenance immunosupression consisted of Tacrolimus (or Cyclosporine) and steroids in both groups. Donor byopsies were taken during the organ procurement, cold storage, and 1 hour after re-vascularization.
Patient survival at 3 months was 100%. There was no incidence of PNF and no need for re-transplantation. The incidence of acute rejection was similar in both groups. Patients with TG had significanly decreases in alanine amino transferase and total bilirubin.
The group concluded that TG allowed for more compromised liver grafts to be transplanted with less clinical evidence or ischemia/reperfusion injury and improved function. You can read the article here...
Clin Transplant 2005: 19: 507-511
Clin Transplant 2005: 19: 507-511
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