TY - JOUR
T1 - Efficacy and safety of steroid therapy for posttransplant hyperbilirubinemia caused by early allograft dysfunction
T2 - A randomized controlled trial
AU - Yang, Jie
AU - Yang, Lei
AU - Wu, Linwei
AU - Zhao, Qiang
AU - Chen, Maogen
AU - He, Xiaoshun
N1 - Funding Information:
* Jie Yang and Lei Yang contributed equally to the article and should be considered as co-first authors Xiaoshun He, e-mail: [email protected] This study was supported by the National Natural Science Foundation of China (grant no. 81373156, 81471583, and 81570587)
Publisher Copyright:
© Med Sci Monit,.
PY - 2019
Y1 - 2019
N2 - Background: Hyperbilirubinemia is a common event that occurs after liver transplantation. Hyperbilirubinemia is usually caused by early allograft dysfunction. Glucocorticoid is widely used for immunosuppression, but few studies have analyzed the effects of steroid therapy on posttransplantation hyperbilirubinemia. The aim of this study was to assess whether glucocorticoid was beneficial in treating hyperbilirubinemia caused by early allograft dysfunction. Material/Methods: Patients with postoperative hyperbilirubinemia (those with conditions such as biliary complications and rejections were excluded) were randomly assigned, in a 2: 1 ratio, to the steroid and control groups. Patients in the steroid group were treated with glucocorticoid combined with ursodeoxycholic acid, whereas patients in the control group were only treated with ursodeoxycholic acid. The primary endpoint was decrease in bilirubin and the secondary endpoint was safety. Results: From 1 st June 2016 to 30 th April 2018, 40 patients were enrolled into the steroid group, and 20 were enrolled into the control group. Donor, recipient, and operative data were similar between the 2 groups. The decrease in bilirubin levels in the steroid group was significantly greater than that in the control group on the first day after the intervention was finished (9.25±1.30 mg/dL vs. 3.11±1.45 mg/dL, p=0.005), and after 2 weeks (15.01±1.20 mg/dL vs. 8.88±1.98 mg/dL, p=0.007). The steroid group did not have a higher complication rate but it did have a shorter postoperative hospital stay than in the control group. Conclusions: Low-dose steroid therapy was effective and safe for treating hyperbilirubinemia caused by early graft dysfunction, and it improved liver function.
AB - Background: Hyperbilirubinemia is a common event that occurs after liver transplantation. Hyperbilirubinemia is usually caused by early allograft dysfunction. Glucocorticoid is widely used for immunosuppression, but few studies have analyzed the effects of steroid therapy on posttransplantation hyperbilirubinemia. The aim of this study was to assess whether glucocorticoid was beneficial in treating hyperbilirubinemia caused by early allograft dysfunction. Material/Methods: Patients with postoperative hyperbilirubinemia (those with conditions such as biliary complications and rejections were excluded) were randomly assigned, in a 2: 1 ratio, to the steroid and control groups. Patients in the steroid group were treated with glucocorticoid combined with ursodeoxycholic acid, whereas patients in the control group were only treated with ursodeoxycholic acid. The primary endpoint was decrease in bilirubin and the secondary endpoint was safety. Results: From 1 st June 2016 to 30 th April 2018, 40 patients were enrolled into the steroid group, and 20 were enrolled into the control group. Donor, recipient, and operative data were similar between the 2 groups. The decrease in bilirubin levels in the steroid group was significantly greater than that in the control group on the first day after the intervention was finished (9.25±1.30 mg/dL vs. 3.11±1.45 mg/dL, p=0.005), and after 2 weeks (15.01±1.20 mg/dL vs. 8.88±1.98 mg/dL, p=0.007). The steroid group did not have a higher complication rate but it did have a shorter postoperative hospital stay than in the control group. Conclusions: Low-dose steroid therapy was effective and safe for treating hyperbilirubinemia caused by early graft dysfunction, and it improved liver function.
KW - Hyperbilirubinemia
KW - Liver Transplantation
KW - Methylprednisolone
KW - Primary Graft Dysfunction
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U2 - 10.12659/MSM.915128
DO - 10.12659/MSM.915128
M3 - Article
C2 - 30870403
AN - SCOPUS:85062952950
SN - 1234-1010
VL - 25
SP - 1936
EP - 1944
JO - Medical Science Monitor
JF - Medical Science Monitor
ER -