The Effect of Octreotide on Urine Output During Orthotopic Liver Transplantation and Early Postoperative Renal Function; A Randomized, Double-Blind, Placebo-Controlled Trial

Abstract

BackgroundMaintenance of the adequate intraoperative renal perfusion is very important during Orthotopic Liver Transplantation (OLT) to prevent acute renal failure.ObjectivesFor the first time, this study was designed to survey the effects of octreotide on urine output during anesthesia for OLT and early postoperative renal function.Patients and MethodsIn this randomized double-blind placebo controlled clinical trial, 79 of 89 patients who underwent OLT and fulfilled the study requirement were randomly allocated into two groups. In the octreotide group, the patients received octreotide infusion from the start of the operation. On the other hand, the control group patients received physiologic saline infusion instead of octreotide. The Mean Arterial Pressure (MAP), heart rate, urine output, norepinephrine usage, and dosage during the three stages of OLT, and baseline and postoperative creatinine were recorded and compared between the two groups.ResultsNo significant differences were found between the two groups regarding the demographic characteristics and graft factors (P > 0.05). However, urine output and MAP during the three stages of OLT were significantly higher in the octreotide group compared to the control group (P < 0.05). Moreover, no significant difference was observed between the two groups regarding baseline as well as postoperative creatinine (P > 0.05).ConclusionsThe results demonstrated that octreotide infusion during anesthesia for OLT not only augmented the vasoconstriction effect of norepinephrine to increase MAP, but also maintained better renal perfusion and urine output during the operation.

Organ protection in allograft recipients

“…Twenty studies reporting on anesthetic strategies aiming at reducing postoperative morbidity and mortality were eventually included (Table 1) [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41]. We retrieved 14 studies reporting on postoperative complications in patients undergoing liver transplantation [22][23][24]28,29,[31][32][33][35][36][37][39][40][41], five studies conducted in kidney recipients [26,27,30,34,38] and one reporting on lung recipients [25].…”

“…Vasoactive drugs have been suggested to increase the splanchnic vascular tone, restore an adequate renal perfusion and be effective in 40-50% of patients with hepatorenal syndrome [60]. [37] investigated the protective effect of octreotide on renal function in 89 patients: the octreotide group had a significantly higher urine output, but there was no difference in the postoperative serum creatinine levels or need for RRT. Sahmeddini and coll.…”

Complex ultrasonography in the assessment of intrarenal hemodynamic impairments in patients with portal hypertension

“…Развитие асцита вследствие прогрессирования портальной гипертензии на ранней стадии заболевания или при первичном эпизоде декомпенсации ЦП имеет место в 20-75% случаев. Ультразвуковое исследование (УЗИ) является первым методом в диагностике ЦП и определении признаков развивающейся портальной гипертензии [5,6].…”

Impact of Intraoperative Norepinephrine Support on Living Donor Liver Transplantation Outcomes: A Retrospective Cohort Study of 430 Children

“…Most LT anesthesiologists have tended to use norepinephrine (NE), which is one of the powerful vasoconstrictors released by sympathetic nerve endings and one of the most widely used cardiovascular active drugs in clinical anesthesia, to maintain hemodynamic stability during LT anesthesia. Previous studies have shown that intraoperative application of vasoconstrictors could reduce the occurrence of postreperfusion syndrome (Ryu et al, 2012), improve renal perfusion (Fayed et al, 2013;Sahmeddini et al, 2013) and reduce the frequency of percutaneous interventions and the length of hospital stay (Reddy et al, 2017). However, there is little evidence focusing on the relationship between intraoperative vasoconstrictor infusion and the prognosis of LT, especially LDLT in children.…”