Differentiated Therapy with Prostaglandin E1 (Alprostadil) after Orthotopic Liver Transplantation: the Usefulness of Procalcitonin (PCT) and Hepatic Artery Resistive Index (RI) for the Evaluation of Early Graft Function and Clinical Course
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Abstract
Increasing demand for donor organs has led to new pharmacological concepts for reducing ischemiareperfusion injury (I/R) of the graft after liver transplantation to prevent primary non-functioning of the organ. Prostaglandins have proved to be cytoprotective in several experimental models of ischemia and transplantation. The prophylactic administration after orthotopic liver transplantation is still a subject of controversial discussion. The aim of our study was the evaluation of the post-transplant hepatic artery resistive index (RI) measured by color Doppler imaging, in combination with postoperative elevation of transaminases, as parameters indicating the need for a differentiated systemic therapy with prostaglandin E1 (PGE1) (alprostadil). In addition, the value of serum procalcitonin (PCT) as a postoperative parameter for the extent of I/R is investigated. In the case of post-transplant elevated hepatic artery RI (RI > 0.75), the administration of PGE1 led to a significant reduction of transaminases (p < 0.05) and a decline of the RI. In addition, postoperative PCT levels could be reduced significantly by PGE1 application. These results suggest that determination of RI is feasible for indicating a need for therapy with PGE1. Its targeted application reduces hepatocellular damage due to I/R after liver transplantation.
Copyright © 2000 by Walter de Gruyter GmbH & Co. KG
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Articles in the same Issue
- European Meeting on Biomarkers of Organ Damage and Dysfunction Selected Papers from the Meeting Held in Cambridge, UK April 3rd-7th, 2000
- Kidney Retrieval Conditions Influence Damage to Renal Medulla: Evaluation by Proton Nuclear Magnetic Resonance (NMR) Spectroscopy
- Citrate, Acetate and Renal Medullary Osmolyte Excretion in Urine as Predictor of Renal Changes after Cold Ischaemia and Transplantation
- Comparison of Proteolytic Enzymes and Glutathione S-Transferase Levels in Non-Heart-Beating Donors' (NHBD) Kidney Perfusates
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- A New Approach to the Evaluation of Liver Graft Function by Nuclear Magnetic Resonance Spectroscopy. A Comparative Study between Euro-Collins and University of Wisconsin Solutions
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- Biochemical Evaluation of Patients with Acute Pancreatitis
- Screening for Acute Myocardial Injury: Creatine Kinase Is Comparable to Myoglobin
- Different Time Frames for the Occurrence of Elevated Levels of Cardiac Troponin T and C-Reactive Protein in Patients with Acute Myocardial Infarction
- Determination of Decision Limits for ACS:Systems Cardiac Troponin I
- Stability of Cardiac Troponins and CK-MB Mass Isoenzyme
- Cytokines as Plasma Markers of Abdominal Aortic Aneurysm
- The Early Fall in Levels of S-100 β in Traumatic Brain Injury
- Protein S-100β in Brain and Serum after Deep Hypothermic Circulatory Arrest in Rabbits: Relationship to Perivascular Astrocytic Swelling
- The Effect of Continuous Treatment with Sodium Nitroprusside on the Serum Kinetics of the Brain Marker Protein S-100β in Neonates Undergoing Corrective Cardiac Surgery by Means of Hypothermic Cardiopulmonary Bypass
- Differentiated Therapy with Prostaglandin E1 (Alprostadil) after Orthotopic Liver Transplantation: the Usefulness of Procalcitonin (PCT) and Hepatic Artery Resistive Index (RI) for the Evaluation of Early Graft Function and Clinical Course
- The Postoperative Course of γ-Glutamyl Transpeptidase – a Marker of Cytomegalovirus (CMV) Replication Risk?
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- An Ex Vivo Model of Tolerance vs. Rejection: Comparison of Different Signal Transducers and Activators of Transcription, STAT1, STAT4, STAT5 and STAT6
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