A double-blind, randomized, placebo-controlled trial of prostaglandin E1 in liver transplantation

✍ Scribed by Keith S. Henley; Michael R. Lucey; Daniel P. Normolle; Robert M. Merion; Ian D. McLaren; Bruce A. Crider; Donald S. Mackie; Victoria L. Shieck; Timothy T. Nostrant; Kimberly A. Brown; Darrell A. Campbell Jr; John M. Ham; Henry D. Appelman; Jeremiah G. Turcotte

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 774 KB
• Volume: 21
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.1840210216

✦ Synopsis

A double-blind placebo-controlled trial of intravenous prostaglandin PGE, (40 pg/h) was conducted in adult orthotopic liver transplant recipients. Infusion was started intraoperatively and continued for up to 21 days. Patients were followed up for 180 days postoperatively. Among 172 patients eligible for treatment in the study, 160 could be evaluated (78 PGE1; 82 placebo). Patient and graft survival were similar (PGE,: 16 deaths, 9 retransplantations 17 survivors]; controls: 15 deaths, 6 retransplantations [3 survivorsl). In patients with swlriving grafts, however, PGE, administration resulted in a 23% shorter mean duration of hospitalization following transplantation (PGE,: 24.4 days; controls: 31.8 days; P = .02) and a 40% shorter length of time postoperatively in the intensive care unit (PGE1: 8.2 days; controls 13.7 days; P = .05). Reduced needs for renal support (P = .03) or surgical intervention other than retransplantation (P = .02) were also noted with PGE, use. Further, PGEl administration resulted in a trend toward improved survival rates in patients with mild renal impairment (preoperative serum creatinine 1.5 mg percent or greater; P = .08). Neither the incidence of acute cellular rejection nor of primary nonfunction was significantly different in the two groups. Phlebitis was the only complication that was more common during PGE, administration, (PGE,: 9; controls: 4). These results suggest that PGEl use in hepatic allograft recipients reduces morbidity and may result in sizable cost reductions. (HEPATOLOGY 1995;21:366-372.