title: Impact of stable PGI₂ analog iloprost on early graft viability after liver transplantation: a pilot study.
abstract: BACKGROUND
  Ischemia/reperfusion injury after liver transplantation (LT) may be associated with primary graft dysfunction (PDF) or non-function. Prostaglandins were demonstrated to be beneficial in reducing ischemic injury by improving microcirculation and protecting endothelial cells. The aim of this study was to analyze the effect of the continuously administered prostaglandin I(2) analog iloprost on allograft function after LT.
  
  
  METHODS
  Eighty patients were prospectively randomized and assigned to two groups. Patients in the treatment group received iloprost for seven d after transplantation, and those in the control group did not. The primary end point was graft dysfunction.
  
  
  RESULTS
  The incidence of PDF was 20% (n = 8) in the control group and 5% (n = 2) in the treatment group, respectively (p = 0.087). Four patients in the control group underwent re-transplantation for initial non-function (INF). There was no evidence for INF in the treatment group. Iloprost was associated with improved allograft function. Clinical course and outcome were comparable.
  
  
  CONCLUSIONS
  We suggest iloprost to be beneficial for early post-transplant liver function. If the rate of PDF can be significantly reduced with this treatment concept, it should be analyzed in a larger number of patients (ISRCTN95672167).
authors.affiliation: Department of General, Visceral and Vascular Surgery, Friedrich-Schiller-University, Jena, Germany. erik.baerthel@med.uni-jena.de
authors.forename: Erik
authors.initials: E
authors.lastname: Bärthel
authors.forename: Falk
authors.initials: F
authors.lastname: Rauchfuss
authors.forename: Heike
authors.initials: H
authors.lastname: Hoyer
authors.forename: Olaf
authors.initials: O
authors.lastname: Habrecht
authors.forename: Karin
authors.initials: K
authors.lastname: Jandt
authors.forename: Max
authors.initials: M
authors.lastname: Götz
authors.forename: Rigo
authors.initials: R
authors.lastname: Voigt
authors.forename: Michael
authors.initials: M
authors.lastname: Heise
authors.forename: Gernot
authors.initials: G
authors.lastname: Marx
authors.forename: Utz
authors.initials: U
authors.lastname: Settmacher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D011464:Epoprostenol / Q000031:analogs & derivatives*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D016285:Iloprost / Q000627:therapeutic use*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis; D011446:Prospective Studies; D015427:Reperfusion Injury / Q000517:prevention & control; D014184:Transplantation, Homologous; D014665:Vasodilator Agents / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D014665:Vasodilator Agents; D011464:Epoprostenol; D016285:Iloprost