Background And Aims: Liver disease is usually accompanied with a decline in systemic vascular resistance (SVR). We decided to assess effects of the peri-operative terlipressin infusion on liver donor liver transplantation recipients with respect to haemodynamics and renal parameters.
Methods: After Ethical Committee approval for this prospective randomised controlled study, 50 recipients were enrolled and allotted to control (n = 25) or terlipressin group (n = 25) with simple randomisation method. Terlipressin was infused at 1.0 μg/kg/h and later titrated 1.0-4.0 μg/kg/h to maintain mean arterial pressure (MAP) >65 mmHg and SVR index <2600 dyne.s/cm5(/) m2 till day 4. Nor-epinephrine was used as appropriate. Haemodynamic and transoesophageal Doppler parameters (intraoperative), renal function, peak portal vein blood flow velocity (PPV), hepatic artery resistive index (HARI), urine output (UOP), liver enzymes, catecholamine support were compared intra-operatively and 4 days post-operatively. Desflurane administration was guided with entropy.
Results: Terlipressin maintained better MAP and SVR (P < 0.01) during reperfusion versus controls (66.5 ± 16.08 vs. 47.7 ± 4.7 mmHg and 687.7 ± 189.7 vs. 425.0 ± 26.0 dyn.s/cm(5)), respectively. Nor epinephrine was used in 5 out of 25 versus 20 in controls. Urea, creatinine and UOP were significantly better with terlipressin. PPV was reduced with terlipressin post-reperfusion versus controls (44.8 ± 5.2 vs. 53.8 ± 3.9 ml/s, respectively, P < 0.01) without affecting HARI (0.63 ± 0.06 vs. 0.64 ± 0.05, respectively, P > 0.05) and was sustained post-operatively.
Conclusion: Terlipressin improved SVR and MAP with less need for catecholamines particularly post-reperfusion. Terlipressin reduced PPV without hepatic artery vasoconstriction and improved post-operative UOP.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378076 | PMC |
| http://dx.doi.org/10.4103/0019-5049.153037 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Article Synopsis
- Hepatorenal syndrome-acute kidney injury (HRS-AKI) is a serious complication of chronic liver disease that leads to high rates of illness and death, and terlipressin, a vasopressin analog, shows promise in treating it by effectively managing blood pressure and reducing side effects during continuous infusion.
- This study evaluated the safety and effectiveness of administering terlipressin at a continuous rate of 4 mg/day in patients with HRS-AKI, involving 136 participants who were monitored for their response to treatment and side effects.
- Results indicated that 69.1% of patients experienced a reduction in serum creatinine levels, with an average treatment duration of 7.6 days, although 21.
Long-Term Continuous Terlipressin Infusion Improves Cardiac Reserve in Patients With Decompensated Cirrhosis.
Clin Gastroenterol Hepatol
August 2024
Department of Medicine, University of Melbourne, Victoria, Australia; Victorian Liver Transplant Unit, Austin Health, Heidelberg, Australia; Australian Centre for Transplantation Excellence and Research, Melbourne, Australia; Australian Cardiovascular Collaborative in Liver Transplant Medicine, Melbourne, Australia. Electronic address:
Article Synopsis
- Long-term use of terlipressin, a treatment for hepatorenal syndrome, may improve subclinical cardiac dysfunction in patients with decompensated cirrhosis, as suggested by a study of 22 patients.
- After 12 weeks of terlipressin infusion, patients showed a significant increase in cardiac output in response to stress, indicating improved cardiac reserve.
- The study found that while resting cardiac output decreased, the number of patients with impaired cardiac reserve dropped significantly, highlighting terlipressin's potential benefits in managing cardiac health in liver disease.
Letter to the Editor: Impact of long-term continuous terlipressin infusion on the liver transplant waitlist in an Australian cohort.
Liver Transpl
January 2025
Victorian Liver Transplant Unit, Austin Health, Melbourne, Victoria, Australia.
Effect of Continuous Infusion Therapy With Low-dose Terlipressin Combined With Norepinephrine on Hemodynamics, Inflammatory Markers, and Prognosis in Patients With Severe Septic Shock.
Mil Med
August 2024
Department of Cardiology, Ganzhou People's Hospital, Ganzhou, Jiangxi 341000, China.
Objective: The present study investigated the impact of continuous infusion therapy with low-dose terlipressin (TP) combined with norepinephrine on hemodynamics, inflammatory markers, and prognosis in patients with severe septic shock.
Materials And Methods: Seventy-four patients with severe septic shock were randomly assigned to either a control group (n = 37) or an observation group (n = 37). Patients in the control group received norepinephrine alone, while those in the observation group received a continuous infusion of low-dose TP in addition to norepinephrine.
Severe Bradycardia Associated with the Use of Terlipressin: A Case Report.
Case Rep Gastroenterol
June 2024
Westmead Intensive Care Service, Westmead Hospital, Westmead, NSW, Australia.
Article Synopsis
- Terlipressin can cause bradycardia, typically seen with hypertension, and is generally not monitored in patients receiving it.
- A case study of a 77-year-old woman with no heart issues developed severe bradycardia and hypotension after receiving terlipressin for cholangitis and variceal bleeding.
- The study suggests that terlipressin could affect older patients differently, possibly necessitating cardiac monitoring for the elderly, even though such effects aren't commonly highlighted in existing safety literature.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!