Adjuvant treatment with ursodeoxycholic acid reduces acute rejection after liver transplantation.
Acute rejection, occurring with a reported frequency of 50-70%, is still a dominating problem after liver transplantation. Medication with ursodeoxycholic acid (UDCA) has beneficial effects in different cholestatic conditions and has also been shown to reduce HLA class I antigen expression on hepatocytes in patients with PBC. Since August 1989 we have consecutively treated all patients with primary graft function with UDCA (n = 41). Patients transplanted in the first half of 1989 served as a control group (n = 8). All patients in this study were given sequential quadruple drug immunosuppression. The treatment group were given oral UDCA 10 mg/kg per day. During the first postoperative month, 17% of the UDCA-treated patients had an episode of acute rejection compared with 75% of the control patients (P < 0.01). Liver biochemistry tests 1 month postoperatively were significantly better in patients treated with UDCA. The results suggest that adjuvant treatment with UDCA reduces acute liver graft rejection.
Friman
S
S
Transplant Unit, Department of Surgery, Sahlgrenska Hospital, University of Gothenburg, Gothenburg, Sweden.
Persson
H
H
Scherstén
T
T
Svanvik
J
J
Karlberg
I
I
D000208:Acute Disease; D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002756:Cholagogues and Choleretics / Q000627:therapeutic use*; D006084:Graft Rejection / Q000517:prevention & control*; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000276:immunology* / Q000401:mortality / Q000473:pathology / Q000502:physiology; D008875:Middle Aged; D020858:Tissue and Organ Harvesting / Q000379:methods; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001663:Bilirubin