title: Effect of ursodeoxycholic acid administration after liver transplantation on serum liver tests and biliary complications: a randomized clinical trial.
abstract: OBJECTIVE
  Endogenous hydrophobic bile acids are suspected to be one of the pathogenetic factors of biliary complications after orthotopic liver transplantation (OLT). This study was designed to investigate the effects of hydrophilic ursodeoxycholic acid (UDCA) administration early after OLT on serum liver tests and the incidence of biliary complications.
  
  
  METHODS
  112 adult patients undergoing OLT from donation after cardiac death (DCD) were randomized to UDCA (13-15 mg/kg/day for 4 weeks; 56 patients) or placebo (56 patients). Serum liver tests and serum bile acids of all patients and biliary bile acids in patients with T-tube drainage were determined during the 4 weeks after OLT. Biliary complications as well as patient and graft survival were analyzed during a mean follow-up of 41.6 months.
  
  
  RESULTS
  UDCA treatment decreased ALT, AST and GGT (p < 0.05) during the 4 weeks after OLT and the incidence of biliary sludge and casts within the 1st year (p < 0.05). However, no differences in the incidence of other biliary complications as well as 1-, 3- and 5-year graft and patient survival were observed.
  
  
  CONCLUSIONS
  UDCA administration early after DCD-OLT improves serum liver tests and decreases the incidence of biliary sludge and casts within the 1st postoperative year but does not affect overall outcome up to 5 years after OLT.
authors.affiliation: Department of General Surgery, Shanghai First People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Shu-Yun
authors.initials: SY
authors.lastname: Wang
authors.forename: Hua-Mei
authors.initials: HM
authors.lastname: Tang
authors.forename: Guo-Qing
authors.initials: GQ
authors.lastname: Chen
authors.forename: Jun-Ming
authors.initials: JM
authors.lastname: Xu
authors.forename: Lin
authors.initials: L
authors.lastname: Zhong
authors.forename: Zhao-Wen
authors.initials: ZW
authors.lastname: Wang
authors.forename: Gui-Long
authors.initials: GL
authors.lastname: Deng
authors.forename: Tong-Hai
authors.initials: TH
authors.lastname: Xing
authors.forename: Lun-Gen
authors.initials: LG
authors.lastname: Lu
authors.forename: Zhi-Hai
authors.initials: ZH
authors.lastname: Peng
mesh_terms: D001646:Bile / Q000737:chemistry*; D001647:Bile Acids and Salts / Q000378:metabolism*; D001649:Bile Duct Diseases / Q000378:metabolism / Q000517:prevention & control*; D002756:Cholagogues and Choleretics / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D006085:Graft Survival; D006801:Humans; D008111:Liver Function Tests; D016031:Liver Transplantation; D016896:Treatment Outcome; D014580:Ursodeoxycholic Acid / Q000008:administration & dosage*
chemical_list: D001647:Bile Acids and Salts; D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid