Tauroursodeoxycholic acid administration as adjuvant therapy in cirrhotic patients on transplantation waiting lists

Background/Aims: The lack of organ availability and an increased number of end-stage cirrhotic patients has led to the lengthening of liver transplant ation waiting lists. The progressive worsening of clinical and functional p erformance in patients awaiting the graft is one of the factors implicated in the increased mortality during the wait; and in poor transplantation out come. In this work our aim was to evaluate the effects of tauroursodeoxycho lic acid administration on biochemical, clinical and functional parameters in a group of cirrhotic patients consecutively placed onto our liver transp lantation waiting list. Methodology: Ten cirrhotic patients underwent biochemical, clinical and fun ctional evaluation at the time of Entering on our liver transplantation wai ting list, then tauroursodeoxycholic acid was administered until liver tran splantation. Complete evaluation was repeated every 2 months. The results w ere compared to those of a comparable historical control group that had und ergone liver transplantation the year before the study. Results: All patients were transplanted within 6 months from insertion on t he waiting list. Longitudinal analysis of the treated group showed that cho lestasis and cytolisis parameters constantly decreased and that 1-glutamyl transpeptidase was significantly lower compared to baseline values at the 4 th month of therapy. Clinical and functional parameters remained stable dur ing follow-up. Comparison with the control group showed that gamma-glutamyl transpeptidase, alkaline phosphatase and both aminotransferases were reduc ed at the 4th month of therapy. Fewer days of hospital stay and less intens ive care were required in the treated group. Conclusions: Treatment of end-stage cirrhotic patients awaiting liver trans plantation with tauroursodeoxycholic acid improves biochemical parameters o f cytolisis and cholestasis, and furthermore helps to maintain clinical and functional stability during the wait. Improved biochemical conditions and steady clinical-functional performance may promote better short-term transp lant outcome.