From the Health Policy Research Center, Institute of Health, Shiraz, Iran.
Exp Clin Transplant. 2022 Sep;20(9):835-841. doi: 10.6002/ect.2022.0080. Epub 2022 Jul 22.
Acute kidney injury and early allograft dysfunction are 2 common complications after liver transplant. Octreotide, through its various mechanisms, may have a role in preventing these complications.
In this randomized, double- blind placebo-controlled clinical trial, we randomly assigned 50 patients who underwent deceased donor liver transplant and fulfilled the study inclusion requirements to receive either octreotide infusion for 3 days in the first 3 days after transplant in the intensive care unit or placebo. The eligible patients were properly informed while on the transplant wait list and gave their consent to participate in the study. The rates of acute kidney injury within the first 7 days after transplant (based on KDIGO criteria), early allograft dysfunction, and nosocomial infection; total length of hospital stays and intensive care unit admissions; and intubation time were recorded and compared between the 2 groups.
No significant differences were found between the 2 groups with regard to demographic characteristics and graft factors (P > .05). However, acute kidney injury, early allograft dysfunction, and nosocomial infection rates were significantly lower in the octreotide group compared with the control group (P < .05). Moreover, a significant difference was observed between the 2 groups with regard to length of hospital stay and intensive care unit admissions (P < .05). For infection, female patients had a higher likelihood of infection than male patients (odds ratio = 23.19). Intensive care unit admission was associated with a higher probability of early graft dysfunction (odds ratio = 1.34). In contrast, longer intubation time was associated with a decrease in the probability of early graft dysfunction (odds ratio = 0.93).
This study showed that octreotide infusion in the first 3 days after liver transplant could improve renal and allograft function and reduce infection and length of hospital stay.
急性肾损伤和早期移植物功能障碍是肝移植后常见的两种并发症。奥曲肽通过其多种机制，可能在预防这些并发症中发挥作用。
在这项随机、双盲安慰剂对照的临床试验中，我们将 50 名符合研究纳入标准的接受已故供体肝移植的患者随机分为两组，分别在移植后前 3 天的重症监护病房中接受奥曲肽输注 3 天或安慰剂。在移植等待名单上，符合条件的患者得到了适当的告知，并同意参与研究。记录并比较两组患者在移植后 7 天内急性肾损伤（基于 KDIGO 标准）、早期移植物功能障碍和医院感染的发生率、总住院时间和重症监护病房入住时间以及插管时间。
两组患者在人口统计学特征和移植物因素方面无显著差异（P＞.05）。然而，奥曲肽组急性肾损伤、早期移植物功能障碍和医院感染的发生率明显低于对照组（P＜.05）。此外，两组患者的住院时间和重症监护病房入住时间也存在显著差异（P＜.05）。对于感染，女性患者比男性患者更容易发生感染（优势比=23.19）。入住重症监护病房与早期移植物功能障碍的发生概率更高相关（优势比=1.34）。相反，较长的插管时间与早期移植物功能障碍的发生概率降低相关（优势比=0.93）。
本研究表明，肝移植后前 3 天输注奥曲肽可改善肾功能和移植物功能，减少感染和住院时间。
