title: Effect of dexmedetomidine on hepatic ischemia-reperfusion injury in the setting of adult living donor liver transplantation.
abstract: OBJECTIVE
  The aim of this study was to investigate the hypothesis that intraoperative infusion of dexmedetomidine can exert a protective effect against hepatic ischemia-reperfusion injury (IRI) in adult living donor liver transplantation (LDLiver transplantation).
  
  
  METHODS
  Forty recipients were allocated into: control group (group I; n = 20) that received a placebo; and dexmedetomidine group (group II; n = 20) that received a continuous intraoperative infusion of 0.8 μg/kg/h of dexmedetomidine. Data collected were AST, ALT, bilirubin, INR, and lactate, at baseline, immediately post-operatively, and on post-operative days 1, 3, and 5. Intercellular adhesion molecule-1 (ICAM-1) was measured at: baseline, 2 and 6 h after reperfusion, and on post-operative day 1. At the end of the surgery, a liver biopsy was sent for histopathological assessment.
  
  
  RESULTS
  No significant difference was noticed in either group regarding MELD score, baseline AST, ALT, bilirubin, INR, or lactate. Dexmedetomidine tended to decrease blood pressure and heart rate, but the comparison was insignificant. Group II showed significantly attenuated levels of ICAM-1 and significantly minimal histopathological changes. The laboratory changes showed significantly lower AST, ALT, bilirubin, INR, and lactate in group II.
  
  
  CONCLUSIONS
  Dexmedetomidine exerted protective effects against hepatic IRI during adult LDLiver transplantation, as indicated by suppression of ICAM-1, better scores of histopathological assessment, and augmented post-operative liver function tests.
authors: Anesthesia and Intensive Care, National Liver Institute, Menoufia University, ShebeenAlkoom, Menoufia, Egypt.
authors: Nirmeen A
authors: NA
authors: Fayed
authors: Anesthesia and Intensive Care, National Liver Institute, Menoufia University, ShebeenAlkoom, Menoufia, Egypt.
authors: Eman I
authors: EI
authors: Sayed
authors: Hepatobiliary Surgery, National Liver Institute, Menoufia University, ShebeenAlkoom, Menoufia, Egypt.
authors: Sherif M
authors: SM
authors: Saleh
authors: Pathology, National Liver Institute, Menoufia University, ShebeenAlkoom, Menoufia, Egypt.
authors: Nermen A
authors: NA
authors: Ehsan
authors: Clinical Biochemistry, National Liver Institute, Menoufia University, ShebeenAlkoom, Menoufia, Egypt.
authors: Ashraf Y
authors: AY
authors: Elfert
mesh_terms: D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D001706:Biopsy; D016022:Case-Control Studies; D020927:Dexmedetomidine / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D006085:Graft Survival; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000601:surgery; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D020011:Protective Agents / Q000627:therapeutic use*; D015427:Reperfusion Injury / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D012307:Risk Factors
chemical_list: D018712:Analgesics, Non-Narcotic; D020011:Protective Agents; D020927:Dexmedetomidine
keywords: ICAM-1; dexmedetomidine; ischemia-reperfusion; liver biopsy; liver transplant