ABSTRACT
Objective To evaluate the effects of ulinastatin on acute lung injury during ortho- topic liver transplantation(OLT).Methods Twenty ASAⅢ-Ⅳpatients with end-stage liver disea- ses.undergoing OLT were randomly divided into two groups.Ulinastatin group received intravenous infusion of ulinastatin(3?10~4 IU in 100 normal saline)after skin incision and every 4 h thereafter(n =10).Control group received same amount of normal saline instead of ulinastatin(n=10).Blood sam- pies were taken before skin incision,120 min after skin incision,30 min after liver was removed,5 min and 60 min after reperfusion of the graft and at the end of operation for determination of plasma IL-6, IL-8,TNF-?,MDA concentrations and SOD activity.Respiratory index(RI)[P_(A-a)DO_2/PaO_2]was cal- culated before skin incision,30 min after liver was removed,5 min and 60 min after reperfusion of the graft and at the end of operation.After anesthesia was induced,cardiac output,mixed venous oxygen saturation and central venous temperature were continuously monitored during operation.ECG,CVP, SpO_2,P_(ET)CO_2,radial artery and MPAP were also continuously monitored during operation.P_(ET)CO_2 was maintained at 35-40 mm Hg during operation.Blood temperature was maintained above 35.5℃during operation.Results In group C plasma IL-6 and IL-8 concentrations were significantly increased from 120 min after skin incision to the end of operation as compared with the baseline values(P0.05).RI was significantly lower at 60 min after reperfusion of the graft and at the end of operation in group U than in group C(P
ABSTRACT
Objective To investigate the effects of ulinastatin on the expression of neutrophil CD_(11b) and CD_(18) during orthotopic liver transplantation(OLT).Methods Forty patients with liver diseases,ASAⅢorⅣ, undergoing OLT were randomly divided into two groups.Ulinastatin group(n=20)received intravenous infusion of ulinastatin 3?10~5 IU in 100 ml normal saline after skin incision and repeated every 4 hours thereafter.Control group received same amount of normal saline instead(n=20).Blood samples were taken immediately before skin incision,120 min after skin incision,30 min of anhepatic phase,60 min of neohepatic phase and at the end of operation for measurement of CD_(11b) and CD_(18) expression of neutrophil by flow cytometry.Results CD_(11b)/CD_(18) expression was increased significantly in control group 60 min of neohepatic phase and at the end of operation compared to the level before skin incision,but in ulinastatin group there was no significant change in CD_(11b)/CD_(18) expression during the whole procedures(P＞0.05).CD_(11b)/CD_(18)expression was significantly lower 60 min of neohepatic phase and at the end of operation in ulinastatin group than in control group(P＜0.01).Conclusion Ulinastatin can inhibit the increase in CD_(11b)/CD_(18)expression during OLT,and be helpful for reducing the inflammatory response.