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High preoperative bilirubin values protect against reperfusion injury after live donor liver transplantation.
Spetzler, Vinzent N; Goldaracena, Nicolas; Kaths, Johann M; Marquez, Max; Selzner, Nazia; Cattral, Mark S; Greig, Paul D; Lilly, Les; McGilvray, Ian D; Levy, Gary A; Ghanekar, Anand; Renner, Eberhard L; Grant, David R; Selzner, Markus.
Afiliação
  • Spetzler VN; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
  • Goldaracena N; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
  • Kaths JM; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
  • Marquez M; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
  • Selzner N; Department of Medicine, Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
  • Cattral MS; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
  • Greig PD; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
  • Lilly L; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
  • McGilvray ID; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
  • Levy GA; Department of Medicine, Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
  • Ghanekar A; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
  • Renner EL; Department of Medicine, Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
  • Grant DR; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
  • Selzner M; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
Transpl Int ; 28(11): 1317-25, 2015 Nov.
Article em En | MEDLINE | ID: mdl-26147741
Heme Oxygenase-1 and its product biliverdin/bilirubin have been demonstrated to protect against ischemia/reperfusion injury (IRI). We investigated whether increased preoperative bilirubin values of transplant recipients decrease IRI. Preoperative bilirubin levels of live donor liver recipients were correlated to postoperative liver transaminase as a marker of IRI. Additionally, two recipient groups with pretransplant bilirubin levels >24 µmol/l (n = 348) and ≤24 µmol/l (n = 118) were compared. Post-transplant liver function, complications, length of hospital stay, and patient and graft survival were assessed. Preoperative bilirubin levels were negatively correlated to the postoperative increase in transaminases suggesting a protective effect against IRI. The maximal rise of ALT after transplantation in high versus low bilirubin patients was 288 (-210-2457) U/l vs. 375 (-11-2102) U/l, P = 0.006. Bilirubin remained a significant determining factor in a multivariate linear regression analysis. The MELD score and its individual components as a marker of severity of chronic liver disease were significantly higher in the high versus low bilirubin group (P < 0.001). Despite this, overall complication rate (21.0% vs. 21.2%, P = 0.88), hospital stay [13 (4-260) vs. 14 (6-313) days, P = 0.93), and 1-year graft survival (90.8% vs. 89.0%, P = 0.62) were similar in both groups. High bilirubin levels of liver recipients before live donor transplantation is associated with decreased postoperative IRI.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Bilirrubina / Traumatismo por Reperfusão / Transplante de Fígado / Doadores Vivos / Hepatopatias Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Transpl Int Assunto da revista: TRANSPLANTE Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Canadá

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Bilirrubina / Traumatismo por Reperfusão / Transplante de Fígado / Doadores Vivos / Hepatopatias Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Transpl Int Assunto da revista: TRANSPLANTE Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Canadá