Effects of Continuous Octreotide Infusion on Intraoperative Transfusion Requirements During Orthotopic Liver Transplantation

Byram, Scott; Gupta, Rachit; Ander, Michael; Edelstein, Steven B.; Andreatta, B.

doi:10.1016/j.transproceed.2015.07.036

Cited by 11 publications

(9 citation statements)

References 6 publications

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“…18 Byram et al were unable to show a significant reduction in the need for intraoperative PRBC transfusion in their retrospective review. 16 Vasopressin and its long-acting synthetic analog, terlipressin, are splanchnic arteriolar vasoconstrictors, and their end effects on portal flow are thought to be similar to those of octreotide. Both agents are used for bleeding varices and hepatorenal syndrome.…”

Section: Pharmacological Methodsmentioning

confidence: 99%

“…15 The splanchnic circulation maintains circulating blood volume; by decompressing the portal system, blood can be shifted to the central circulation, which results in less venous congestion and potentially less blood loss during the dissection of the diseased liver to the completion of hepatectomy. 15,16 This can also result in increased systemic circulation and potentially preserve renal function. Both pharmacologic and surgical methods are used to decompress the portal system during LT.…”

Section: Intraoperative Portal Venous Decompressionmentioning

confidence: 99%

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Perioperative management of adult living donor liver transplantation: Part 1 – recipients

Sakai

Crouch

et al. 2022

Clinical Transplantation

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Living donor liver transplantation was first developed to mitigate the limited access to deceased donor organs in Asia in the 1990s. This alternative liver transplantation option has become an established and widely practiced transplantation method for adult patients suffering from end-stage liver disease. It has successfully addressed the shortage of deceased donors. The Society for the Advancement of Transplant Anesthesia and the Korean Society of Transplant Anesthesia jointly reviewed published studies on the perioperative management of live donor liver transplant recipients. The review aims to offer transplant anesthesiologists and critical care physicians a comprehensive overview of the perioperative management of adult live liver transplantation recipients. We feature the status, outcomes, surgical procedure, portal venous

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Section: Pharmacological Methodsmentioning

confidence: 99%

Section: Intraoperative Portal Venous Decompressionmentioning

confidence: 99%

Perioperative management of adult living donor liver transplantation: Part 1 – recipients

Sakai

Crouch

et al. 2022

Clinical Transplantation

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“…10 22 23 Previous clinical studies of octreotide in liver transplantation A retrospective cohort study of octreotide infusion during liver transplantation demonstrated a reduction in transfusion requirement by 2.3 units of packed red blood cells but this difference was not statistically significant. 24 A randomised controlled trial (RCT) of octreotide infusion during liver transplantation found an enhancement of norepinephrine effect on blood pressure with a mean increase of 8 mm Hg. 15…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…The side effect profile of octreotide during liver transplantation is unknown. The studies to date did not compare safety or adverse events between the octreotide and placebo arms,15 have not been fully published25 or did not assess adverse events 24…”

Section: Introductionmentioning

confidence: 99%

Protocol for a prospective double-blind, randomised, placebo-controlled feasibility trial of octreotide infusion during liver transplantation

et al. 2021

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IntroductionLiver transplantation is a complex operation that can provide significant improvements in quality of life and survival to the recipients. However, serious complications are common and include major haemorrhage, hypotension and renal failure. Blood transfusion and the development of acute kidney injury lead to both short-term and long-term poor patient outcomes, including an increased risk of death, graft failure, length of stay and reduced quality of life. Octreotide may reduce the incidence of renal dysfunction, perioperative haemorrhage and enhance intraoperative blood pressure. However, octreotide does have risks, including resistant bradycardia, hyperglycaemia and hypoglycaemia and QT prolongation. Hence, a randomised controlled trial of octreotide during liver transplantation is needed to determine the cost-efficacy and safety of its use; this study represents a feasibility study prior to this trial.Methods and analysisWe describe a multicentre, double-blind, randomised, placebo-controlled feasibility study of continuous infusion of octreotide during liver transplantation surgery. We will recruit 30 adult patients at two liver transplant centres. A blinded infusion during surgery will be administered in a 2:1 ratio of octreotide:placebo. The primary outcomes will determine the feasibility of this study design. These include the recruitment ratio, correct administration of blinded study intervention, adverse event rates, patient and clinician enrolment refusal and completion of data collection. Secondary outcome measures of efficacy and safety will help shape future trials by assessing potential primary outcome measures and monitoring safety end points. No formal statistical tests are planned. This manuscript represents study protocol number 1.3, dated 2 June 2021.Ethics and disseminationThis study has received Research Ethics Committee approval. The main study outcomes will be submitted to an open-access journal.Trial sponsorThe Joint Research Office, University College London, UK.Neither the sponsor nor the funder have any role in study design, collection, management, analysis and interpretation of data, writing of the study report or the decision to submit the report for publication.Trial registrationThe study is registered with ClinicalTrials.gov (NCT04941911) with recruitment due to start in August 2021 with anticipated completion in July 2022.Clinical trials unitSurgical and Interventional Group, Division of Surgery & Interventional Science, University College London.

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“…Στο προτεινόμενο ερευνητικό έργο, εξετάσαμε το χημικό μόριο, 21 -αμινοστεροειδές U -74389 G (λαζαροειδές) 4,[6][7][8][9][10][11] και τις φαρμακευτικές ουσίες Ερυθροποιητίνη , Σιλδεναφίλη [34][35][36][37][38][39][40][41] και Οκτρεοτίδη [42][43][44][45][46][47][48][49][50][51] .…”

Section: _____________________________________ 63unclassified

Μορφολογική, Βιοχημική Και Μοριακή Μελέτη Της Προστατευτικής Δράσης Των Μορίων U-74389g (Λαζαροειδές), Της Ερυθροποιητίνης, Της Συλδεναφίλης Και Της Οκτρεοτίδης Στην Συντήρηση Ήπατος Για Μεταμόσχευση

Χαλαστή¹

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Η μεταμόσχευση αποτελεί τη θεραπεία εκλογής στην τελικού σταδίου ανεπάρκεια των ζωτικών οργάνων. Η ζήτηση για ακόμα μεγαλύτερη δωρεά και διανομή ανθρωπίνων οργάνων προς μεταμόσχευση, ακολουθώντας τους διεθνείς κανόνες ιατρικής πρακτικής και δεοντολογίας, δημιουργεί τεράστιες ανάγκες σε κλινικό επίπεδο. Οι ιστικές βλάβες των οργάνων από το φαινόμενο της ισχαιμίας / επαναιμάτωσης είναι πάντα παρούσες, με δύσκολα αντιμετωπιζόμενες συνέπειες. Σκοπός αυτής της πειραματικής μελέτης ήταν να εξεταστεί το χημικό μόριο, 21-ανιμοστεροειδές (λαζαροειδές) U-74389 G και οι φαρμακευτικές ουσίες Ερυθροποιητίνη, Σιλδεναφίλη και Οκτρεοτίδη στην πρόληψη των ιστικών βλαβών από την ισχαιμία, με στόχο την καλύτερη διατήρηση του μοσχεύματος για μεταμόσχευση. Στο Ερευνητικό – Πειραματικό Κέντρο ELPEN μελετήθηκαν 56 ζωικά πρότυπα (χοίροι θηλυκού και αρσενικού φύλου >= 20 kg). Τα αποτελέσματα μας έδειξαν ικανές διαφορές στους αιματολογικούς και βιοχημικούς δείκτες καθώς επίσης και στις παθολογοανατομικές παραμέτρους (οίδημα, αιμορραγία, πολυμορφοπύρηνα και νέκρωση). Επίσης προέκυψαν διαφορές και στις μετρήσιμες βιοχημικές παραμέτρους (MDA, MPO και TNF) και των τεσσάρων αυτών φαρμακολογικών παραγόντων. Η κατανόηση του μορφολογικού και μοριακού προφίλ που συμβάλει στην ελαχιστοποίηση των επιπλοκών θα βελτιώσει την ποιότητα της συντήρησης. Μέσα από τα συμπεράσματα της διατριβής, και ειδικότερα του πειράματος, προτείνεται ο σχεδιασμός και η υλοποίηση προοπτικών μελετών μεγάλου μεγέθους για την περαιτέρω αξιολόγηση των αποτελεσμάτων της συγκεκριμένης μελέτης.

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Effects of Continuous Octreotide Infusion on Intraoperative Transfusion Requirements During Orthotopic Liver Transplantation

Cited by 11 publications

References 6 publications

Perioperative management of adult living donor liver transplantation: Part 1 – recipients

Perioperative management of adult living donor liver transplantation: Part 1 – recipients

Protocol for a prospective double-blind, randomised, placebo-controlled feasibility trial of octreotide infusion during liver transplantation

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