PROSTAGLANDIN E(1) ADMINISTRATION FOLLOWING ORTHOTOPIC LIVER-TRANSPLANTATION - A RANDOMIZED PROSPECTIVE MULTICENTER TRIAL

Background & Aims: Prostaglandin 5, (PGE,) has been used after orthoto pic liver transplantation (OLT) based on limited clinical data suggest ing PGE(1) infusion improves immediate hepatic allograft function, The aim of this study was to conduct a randomized double-blinded multicen ter trial to evaluate the effect of PGE(1) on early hepatic and renal function in patients undergoing OLT. Methods: One hundred eighteen pat ients were randomized to receive either PGE(1) or crystalloid placebo intravenously after allograft revascularization, Primary end points we re incidence of primary allograft nonfunction (PNF) or severe renal dy sfunction. Results: The incidence of PNF was 6.7% (4 of 60) and 6.9% ( 4 of 58) in the control and PGE(1) groups, respectively. PGE(1) infusi on was, however, associated with improved early renal function (mean p eak creatinine level of 1.4 +/- 1.0 and 2.0 +/- 1.0 in patients treate d with PGE, and placebo, respectively; P < 0.001), Severe renal dysfun ction occurred more frequently in the placebo group (26.7%) than in th e PGE(1) group (13.8%; P = 0.65). Additionally, dialysis treatments we re more frequent in the placebo group (0.7 +/- 2.0 per patient) than i n the PGE(1) group (0.2 +/- 1.0 per patient; P = 0.10). initial intens ive care unit stay was shorter in patients treated with PGE, (4.0 +/- 3.6 days) compared with controls (10.5 +/- 17.1 days) (P < 0.01), Conc lusions: PGE(1) administration after OLT resulted in improved renal fu nction and decreased initial postoperative intensive care unit stay bu t did not affect the incidence of PNF.