Maureen/UDCA post trans

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Scand J Gastroenterol Suppl 1994;204:62-4 Related Articles, Books,

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A possible role of ursodeoxycholic acid in liver transplantation.

Friman S, Svanvik J.

Dept. of Surgery, Sahlgrenska University Hospital, Goteborg, Sweden.

There are many different causes of graft dysfunction and cholestasis

after liver transplantation. These include non-primary function,

preservation and reperfusion injury, acute rejection, artery

thrombosis, drug toxicity, bile leakage, and bile duct stenosis.

Medication with ursodeoxycholic acid (UDCA) has beneficial effects in

different cholestatic conditions. The initial rationale for its use

after liver transplantation was to alter the bile acid pool to a more

atoxic composition, as liver transplantation can be associated with

cholestasis and can stimulate the initial bile production. We have

consecutively treated 41 patients with primary graft function with

UDCA. During the first postoperative month, 17% of the UDCA treated

patients had an episode of acute rejection compared with 75% of a

historical control group of 8 patients. The results suggest that

adjuvant treatment with UDCA reduces acute liver graft rejection.

This has to be confirmed by controlled prospective trials; one is

presently being carried out in the Nordic countries. Several studies

have indicated an immunomodulating capacity of this bile acid and we

have recently reported our results from a heart transplant model in

the rat, where treatment with UDCA prolonged graft survival.

Improvement in surgical technique and postoperative care as well as

immunosuppressive treatment has improved the results of liver

transplantation. Acute rejection is nowadays a dominating problem

after liver transplantation and the inclusion of UDCA may reduce

morbidity.

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PMID: 7824880 [PubMed - indexed for MEDLINE]