title: [Effect of post-liver transplantation administration of ursodeoxycholic acid on serum liver tests and biliary complications: a randomized clinical trial].
abstract: OBJECTIVE
  Endogenous hydrophobic bile acids may be a pathogenetic factor of biliary complications after orthotopic liver transplantation (OLT).This study was designed to investigate the effects of hydrophilic ursodeoxycholic acid (UDCA), when administered early after OLT, on serum liver tests and on the incidence of biliary complications.
  
  
  METHODS
  A total of 112 adult patients undergoing OLT were randomly assigned to one of two groups for receipt of UDCA (13 to 15 mg/kg/d for 4 weeks, n=56) or a placebo (n=56). All patients underwent serum liver testing and measurement of serum bile acids during the 4 weeks following OLT.Patients with T-tube underwent measurement of biliary bile acids during the 4 weeks following OLT.Biliary complications, as well as patient and graft survival rates, were analyzed during the follow-up period (mean of 65.6 months).
  
  
  RESULTS
  At post-OLT days 7, 21 and 28, the UDCA-treated patients showed significantly lower levels of alanine aminotransferase, aspartate aminotransferase and gamma glutamyl transpeptidase (all P less than 0.05).In addition, the UDCA-treated patients showed significantly lower incidence of biliary sludge and casts within the first year post-OLT (3.6% vs.14.3%; x2=3.953, P=0.047). However, there were no significant differences for the incidence of other biliary complications at post-OLT years 1, 3 and 5.The graft and patient survival rates were also similar between the two groups.
  
  
  CONCLUSIONS
  UDCA, when administered early after OLT, improves results from serum liver tests and decreases the incidence of biliary sludge and casts within the first postoperative year.
authors.affiliation: Departments of General Surgery, Pathology and Gastroenterology, Shanghai First People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200080, China.
authors.forename: Shuyun
authors.initials: S
authors.lastname: Wang
authors.forename: Meihua
authors.initials: M
authors.lastname: Tang
authors.forename: Guoqing
authors.initials: G
authors.lastname: Chen
authors.forename: Junming
authors.initials: J
authors.lastname: Xu
authors.forename: Lin
authors.initials: L
authors.lastname: Zhong
authors.forename: Zhaowen
authors.initials: Z
authors.lastname: Wang
authors.forename: Guilong
authors.initials: G
authors.lastname: Deng
authors.forename: Tonghai
authors.initials: T
authors.lastname: Xing
authors.forename: Lungen
authors.initials: L
authors.lastname: Lu
authors.forename: Zhihai
authors.initials: Z
authors.lastname: Peng
mesh_terms: D000410:Alanine Transaminase; D001219:Aspartate Aminotransferases; D001646:Bile; D001647:Bile Acids and Salts; D001660:Biliary Tract Diseases / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D008099:Liver / Q000503:physiopathology*; D008105:Liver Cirrhosis, Biliary; D008111:Liver Function Tests; D016031:Liver Transplantation; D011183:Postoperative Complications / Q000503:physiopathology*; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*; D005723:gamma-Glutamyltransferase
chemical_list: D001647:Bile Acids and Salts; D014580:Ursodeoxycholic Acid; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase