Downregulation of endothelin-1 by somatostatin improves liver function of recipients undergoing adult-to-adult living donor liver transplantation
- Author:
- No author available
- Journal Title:
- CHINESE MEDICAL JOURNAL
- Issue:
- 15
- DOI:
- 10.3760/cma.j.issn.0366-6999.2010.15.002
- Key Word:
- somatostatin;endothelin-1;liver function tests;liver transplantation
Abstract： Background The aim of this study was to investigate the possible effect of somatostatin on the liver function of recipients undergoing living donor liver transplantation.Methods Forty recipients were randomized into group A (n=20) and group B (n=20). Recipients in group A received no somatostatin whereas somatostatin was administrated for recipients in group B perioperatively. Liver function, the plasma concentration of endothelin-1 and nitric oxide, the intragraft expressions of endothelin-1 and inducible nitric oxide syntheses at 2 hours after declamping of the portal vein were compared between the two groups.Results Compared to group A, alanine transaminase values in group B were significantly reduced at 2 hours after portal vein declamping, at the end of the operation and postoperation day 1 (P ＜0.05), whereas aspartate aminotransferase values in group B decreased at 30 minutes after portal vein clamping, at 2 hours after portal vein declamping and at the end of the operation (P ＜0.05). Total bilirubin values in group B were reduced significantly at 2 hours after portal vein declamping and at the end of the operation when compared to group A (P ＜0.05). Intragraft expression of endothelin-1 was significantly downregulated at 2 hours after declamping of the portal vein accompanied with a reduction of plasma concentration of endothelin-1 in the peripheral blood (P ＜0.05).Conclusions Somatostatin had a protective effect on liver function during the early phase after declamping of portal vein for recipients undergoing living donor liver transplantation, and the possible mechanism might be partially attributed to the downregulation of endothelin-1.
- [1]FENG Xi,YUAN Ding,WEI Yong-gang,etc.Outcomes of adult-to-adult living donor liver transplantation: a single center experience[J].2009,(7).
- [2]CHEN Gui-Hua.Liver transplantation in China: Retrospect and prospect[J].2009,(19).
- [3]YAN Lü-nan,WU Hong,CHEN Zhe-yu,etc.Current status of adult-to-adult living donor liver transplantation: surgical techniques and innovations[J].2009,(24).
- [4]Shimada M,Maehara Y,Kayashima H,etc.Graft size, donor age, and patient status are the indicators of early graft function after living donor liver transplantation[J].2008,14(7).
- [5]Jon B. Morris,Nora H. Guerrero,Emma E. Furth,etc.Somatostatin attenuates ischemic intestinal injury[J].1993,165(6).
- [6]Jimenez JC,Aleixandre IS,Torres JG,etc.Initial poor function in the age of old donors: prognostic factors.[J].2007,39(7).
- [7]Deschenes M,Zetterman RK,Lake JR,etc.Early allograft dysfunction after liver transplantation: a definition and predictors of outcome. National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database.[J].1998,66(3).
- [8]J K, Maring,I J, Klompmaker,J H, Zwaveling,etc.Poor initial graft function after orthotopic liver transplantation: can it be predicted and does it affect outcome? An analysis of 125 adult primary transplantations.[J].1997,11(5 Pt 1).
- [9]Uemoto S,Asonuma K,Egawa H,etc.Right lobe graft in living donor liver transplantation.[J].2000,69(2).
- [10]Menger MD,Vollmar B.The hepatic microcirculation: mechanistic contributions and therapeutic targets in liver injury and repair.[J].2009,89(4).
- [11]Palmes D,Spiegel HU,Armann B,etc.The endothelin/nitric oxide balance determines small-for-size liver injury after reduced-size rat liver transplantation.[J].2005,447(4).
- [12]M K, Li,J J, Sung,K S, Woo,etc.Somatostatin reduces gastric mucosal blood flow in patients with portal hypertensive gastropathy: a randomized, double-blind crossover study.[J].1996,41.
- [13]Yu P,Xu X,Liang T,etc.Reconstruction of middle hepatic vein in living donor liver transplantation with modified right lobe graft: a single center experience.[J].2008,21(9).
- [14]van der Hilst, CS,Peeters, PMJG,Porte, RJ,etc.The Clinical Relevance of the Anhepatic Phase During Liver Transplantation[J].2009,15(9).
- [15]Heise M,Settmacher U,Pfitzmann R,etc.A survival-based scoring-system for initial graft function following orthotopic liver transplantation.[J].2003,16(11).
- [16]Gaebel G,Ludwig S,Hauss J,etc.Attenuation of proinflammatory gene expression and microcirculatory disturbances by endothelin A receptor blockade after orthotopic liver transplantation in pigs.[J].2006,139(1).
- [17]Iannuzzi F,de-Franchis R,Dell'era A.Acute variceal bleeding: Pharmacological treatment and primary/secondary prophylaxis.[J].2008,22(2).
- [18]CIRERA I.Effects of bolus injections and continuous infusions of somatostatin and placebo in patients with cirrhosis: A double-blind hemodynamic investigation*1[J].1995.
- [19]J, Bosch,D, Kravetz,J, Rodes.Effects of somatostatin on hepatic and systemic hemodynamics in patients with cirrhosis of the liver: comparison with vasopressin.[J].1981,80.
- [20]Eisenbach C,Encke J,Merle U.An early increase in gamma glutamyltranspeptidase and low aspartate aminotransferase peak values are associated with superior outcomes after orthotopic liver transplantation.[J].2009,41(5).
- [21]Ferrer JV,Balen E,Lera JM,etc.Metabolism of the intestine with intermediate ischemia after intestinal ischemia-reperfusion injury: therapeutic effects of somatostatin.[J].1999,31(6).
- [22]Vanheule E,Geerts AM,Colle I,etc.Influence of somatostatin and octreotide on liver microcirculation in an experimental mouse model of cirrhosis studied by intravital fluorescence microscopy.[J].2008,28(1).
- [23]R J, Ploeg,A M, D'Alessandro,S J, Knechtle,etc.Risk factors for primary dysfunction after liver transplantation--a multivariate analysis.[J].1993,55.