Prostaglandins in liver transplantation.
This review summarizes experimental studies and clinical experiences with prostaglandins in liver transplantation emphasizing two randomized, double blinded placebo controlled clinical trials of prostaglandin E1 (PGE1) involving nearly 300 liver transplant recipients. Resource utilization and pharmacoeconomic aspects are also discussed. In the randomized trials, PGE1 did not affect patient and graft survival. Acute cellular rejection and primary allograft non-function were not reduced by PGE1. Postoperative renal failure was significantly less frequent among PGE1 patients in both trials and in one study perioperative blood product utilization was significantly lower. PGE1 treated patients had reduced intensive care unit length of stay, shorter hospitalization, and significantly lower total health care charges. Despite its failure to show improvements in patient and graft survival, rejection, or primary non-function, PGE1 use in hepatic allograft recipients reduces morbidity and results in notable reduction in the cost of liver transplantation.
Merion
R M
RM
Department of Surgery, University of Michigan Medical School, Ann Arbor, USA.
D000527:Alprostadil / Q000627:therapeutic use*; D000818:Animals; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation / Q000502:physiology*; D011183:Postoperative Complications / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D051437:Renal Insufficiency / Q000517:prevention & control; D014665:Vasodilator Agents / Q000627:therapeutic use*
D014665:Vasodilator Agents; D000527:Alprostadil