Nafamostat Mesilate Attenuates Postreperfusion Syndrome during Liver Transplantation
Postreperfusion syndrome (PRS), an acute decrease in blood pressure after reperfusion of the liver graft, occurs frequently during liver transplantation surgery. We supposed that the activation of the kallikrein–kinin system leading to extensive systemic vasodilatation was a possible cause. The effe...
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| Veröffentlicht in: | American journal of transplantation 2011-05, Vol.11 (5), p.977-983 |
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| creator | Ryu, H.‐G. Jung, C.‐W. Lee, C.‐S. Lee, J. |
| description | Postreperfusion syndrome (PRS), an acute decrease in blood pressure after reperfusion of the liver graft, occurs frequently during liver transplantation surgery. We supposed that the activation of the kallikrein–kinin system leading to extensive systemic vasodilatation was a possible cause. The effect of pretreatment with nafamostat mesilate (NM), a broad spectrum serine protease inhibitor, on the occurrence of PRS was evaluated. Sixty‐two adult liver recipients were randomized to receive an intravenous bolus of either 0.02 mg/kg of NM (NM group, n = 31) or an equal volume of normal saline (control group, n = 31) just before reperfusion of the liver graft. Occurrence of PRS and intraoperative use of vasoactive drugs were compared between the two groups. Postoperative recovery was also compared. PRS was significantly less frequent (48% vs. 81%, p = 0.016) requiring less vasopressors in the NM group compared to the control group. The NM group also showed faster recovery of the mean arterial pressure. Perioperative laboratory values were similar between the two groups. Pretreatment with 0.02 mg/kg of NM immediately before reperfusion decreases the frequency of PRS and vasopressor requirements during the reperfusion period in liver transplantation.
Nafamostat mesilate administration before reperfusion of the liver graft attenuates the occurrence of postreperfusion syndrome and vasopressor requirements during orthotopic liver transplantation. |
| doi_str_mv | 10.1111/j.1600-6143.2011.03514.x |
| format | Article |
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Nafamostat mesilate administration before reperfusion of the liver graft attenuates the occurrence of postreperfusion syndrome and vasopressor requirements during orthotopic liver transplantation.</description><identifier>ISSN: 1600-6135</identifier><identifier>EISSN: 1600-6143</identifier><identifier>DOI: 10.1111/j.1600-6143.2011.03514.x</identifier><identifier>PMID: 21521468</identifier><language>eng</language><publisher>Malden, USA: Blackwell Publishing Inc</publisher><subject>Adult ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antiviral agents ; Benzamidines ; Biological and medical sciences ; Double-Blind Method ; Female ; Guanidines - therapeutic use ; Humans ; Infusions, Intravenous ; Kallikreins - metabolism ; Kinins - metabolism ; Liver transplantation ; Liver Transplantation - adverse effects ; Liver, biliary tract, pancreas, portal circulation, spleen ; Male ; Medical sciences ; Middle Aged ; Pharmacology. Drug treatments ; Placebos ; Postoperative Complications ; Prospective Studies ; Reperfusion ; Reperfusion Injury - drug therapy ; Reperfusion Injury - etiology ; serine protease inhibitor ; Serine Proteinase Inhibitors - therapeutic use ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Syndrome ; Treatment Outcome ; Vasodilation</subject><ispartof>American journal of transplantation, 2011-05, Vol.11 (5), p.977-983</ispartof><rights>©</rights><rights>2015 INIST-CNRS</rights><rights>2011 The Authors Journal compilation©2011 The American Society of Transplantation and the American Society of Transplant Surgeons.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4314-d9331f1160e4196d489d243853cb6b482960706830dc034bfb5bd89ff3701f0d3</citedby><cites>FETCH-LOGICAL-c4314-d9331f1160e4196d489d243853cb6b482960706830dc034bfb5bd89ff3701f0d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1600-6143.2011.03514.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1600-6143.2011.03514.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24281127$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21521468$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ryu, H.‐G.</creatorcontrib><creatorcontrib>Jung, C.‐W.</creatorcontrib><creatorcontrib>Lee, C.‐S.</creatorcontrib><creatorcontrib>Lee, J.</creatorcontrib><title>Nafamostat Mesilate Attenuates Postreperfusion Syndrome during Liver Transplantation</title><title>American journal of transplantation</title><addtitle>Am J Transplant</addtitle><description>Postreperfusion syndrome (PRS), an acute decrease in blood pressure after reperfusion of the liver graft, occurs frequently during liver transplantation surgery. We supposed that the activation of the kallikrein–kinin system leading to extensive systemic vasodilatation was a possible cause. The effect of pretreatment with nafamostat mesilate (NM), a broad spectrum serine protease inhibitor, on the occurrence of PRS was evaluated. Sixty‐two adult liver recipients were randomized to receive an intravenous bolus of either 0.02 mg/kg of NM (NM group, n = 31) or an equal volume of normal saline (control group, n = 31) just before reperfusion of the liver graft. Occurrence of PRS and intraoperative use of vasoactive drugs were compared between the two groups. Postoperative recovery was also compared. PRS was significantly less frequent (48% vs. 81%, p = 0.016) requiring less vasopressors in the NM group compared to the control group. The NM group also showed faster recovery of the mean arterial pressure. Perioperative laboratory values were similar between the two groups. Pretreatment with 0.02 mg/kg of NM immediately before reperfusion decreases the frequency of PRS and vasopressor requirements during the reperfusion period in liver transplantation.
Nafamostat mesilate administration before reperfusion of the liver graft attenuates the occurrence of postreperfusion syndrome and vasopressor requirements during orthotopic liver transplantation.</description><subject>Adult</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antiviral agents</subject><subject>Benzamidines</subject><subject>Biological and medical sciences</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Guanidines - therapeutic use</subject><subject>Humans</subject><subject>Infusions, Intravenous</subject><subject>Kallikreins - metabolism</subject><subject>Kinins - metabolism</subject><subject>Liver transplantation</subject><subject>Liver Transplantation - adverse effects</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Placebos</subject><subject>Postoperative Complications</subject><subject>Prospective Studies</subject><subject>Reperfusion</subject><subject>Reperfusion Injury - drug therapy</subject><subject>Reperfusion Injury - etiology</subject><subject>serine protease inhibitor</subject><subject>Serine Proteinase Inhibitors - therapeutic use</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Syndrome</subject><subject>Treatment Outcome</subject><subject>Vasodilation</subject><issn>1600-6135</issn><issn>1600-6143</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkMtOwzAQRS0EolD4BZQNgk2Dx3YSZ8GiqniqPCTK2nJiG6XKo9gJtH-PQ0vZIbzxSHNm5uogFAAOwb-LeQgxxqMYGA0JBggxjYCFyx10sG3sbmsaDdChc3OMISGc7KMBgYgAi_kBmj1KI6vGtbINHrQrStnqYNy2uu585YJn37J6oa3pXNHUwcuqVrapdKA6W9RvwbT40DaYWVm7RSlrv8ZTR2jPyNLp480_RK_XV7PJ7Wj6dHM3GU9HOaPARiqlFAz4lJpBGivGU0UY5RHNszhjnKQxTnDMKVY5piwzWZQpnhpDEwwGKzpEZ-u9C9u8d9q1oipcrksfRDedEzymPE0Tv2GIzv8kIeERoZhHiUf5Gs1t45zVRixsUUm7EoBFb1_MRS9W9JJFb1982xdLP3qyudJllVbbwR_dHjjdANLlsjReW164X44RDkD6DJdr7rMo9erfAcT4ftZX9At5559t</recordid><startdate>201105</startdate><enddate>201105</enddate><creator>Ryu, H.‐G.</creator><creator>Jung, C.‐W.</creator><creator>Lee, C.‐S.</creator><creator>Lee, J.</creator><general>Blackwell Publishing Inc</general><general>Wiley</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>201105</creationdate><title>Nafamostat Mesilate Attenuates Postreperfusion Syndrome during Liver Transplantation</title><author>Ryu, H.‐G. ; Jung, C.‐W. ; Lee, C.‐S. ; Lee, J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4314-d9331f1160e4196d489d243853cb6b482960706830dc034bfb5bd89ff3701f0d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Antiviral agents</topic><topic>Benzamidines</topic><topic>Biological and medical sciences</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Guanidines - therapeutic use</topic><topic>Humans</topic><topic>Infusions, Intravenous</topic><topic>Kallikreins - metabolism</topic><topic>Kinins - metabolism</topic><topic>Liver transplantation</topic><topic>Liver Transplantation - adverse effects</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>Placebos</topic><topic>Postoperative Complications</topic><topic>Prospective Studies</topic><topic>Reperfusion</topic><topic>Reperfusion Injury - drug therapy</topic><topic>Reperfusion Injury - etiology</topic><topic>serine protease inhibitor</topic><topic>Serine Proteinase Inhibitors - therapeutic use</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Syndrome</topic><topic>Treatment Outcome</topic><topic>Vasodilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ryu, H.‐G.</creatorcontrib><creatorcontrib>Jung, C.‐W.</creatorcontrib><creatorcontrib>Lee, C.‐S.</creatorcontrib><creatorcontrib>Lee, J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ryu, H.‐G.</au><au>Jung, C.‐W.</au><au>Lee, C.‐S.</au><au>Lee, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nafamostat Mesilate Attenuates Postreperfusion Syndrome during Liver Transplantation</atitle><jtitle>American journal of transplantation</jtitle><addtitle>Am J Transplant</addtitle><date>2011-05</date><risdate>2011</risdate><volume>11</volume><issue>5</issue><spage>977</spage><epage>983</epage><pages>977-983</pages><issn>1600-6135</issn><eissn>1600-6143</eissn><abstract>Postreperfusion syndrome (PRS), an acute decrease in blood pressure after reperfusion of the liver graft, occurs frequently during liver transplantation surgery. We supposed that the activation of the kallikrein–kinin system leading to extensive systemic vasodilatation was a possible cause. The effect of pretreatment with nafamostat mesilate (NM), a broad spectrum serine protease inhibitor, on the occurrence of PRS was evaluated. Sixty‐two adult liver recipients were randomized to receive an intravenous bolus of either 0.02 mg/kg of NM (NM group, n = 31) or an equal volume of normal saline (control group, n = 31) just before reperfusion of the liver graft. Occurrence of PRS and intraoperative use of vasoactive drugs were compared between the two groups. Postoperative recovery was also compared. PRS was significantly less frequent (48% vs. 81%, p = 0.016) requiring less vasopressors in the NM group compared to the control group. The NM group also showed faster recovery of the mean arterial pressure. Perioperative laboratory values were similar between the two groups. Pretreatment with 0.02 mg/kg of NM immediately before reperfusion decreases the frequency of PRS and vasopressor requirements during the reperfusion period in liver transplantation.
Nafamostat mesilate administration before reperfusion of the liver graft attenuates the occurrence of postreperfusion syndrome and vasopressor requirements during orthotopic liver transplantation.</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>21521468</pmid><doi>10.1111/j.1600-6143.2011.03514.x</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Antibiotics. Antiinfectious agents. Antiparasitic agents Antiviral agents Benzamidines Biological and medical sciences Double-Blind Method Female Guanidines - therapeutic use Humans Infusions, Intravenous Kallikreins - metabolism Kinins - metabolism Liver transplantation Liver Transplantation - adverse effects Liver, biliary tract, pancreas, portal circulation, spleen Male Medical sciences Middle Aged Pharmacology. Drug treatments Placebos Postoperative Complications Prospective Studies Reperfusion Reperfusion Injury - drug therapy Reperfusion Injury - etiology serine protease inhibitor Serine Proteinase Inhibitors - therapeutic use Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Syndrome Treatment Outcome Vasodilation |
| title | Nafamostat Mesilate Attenuates Postreperfusion Syndrome during Liver Transplantation |
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