Effects of ulinastatin on perioperative renal function in patients undergoing orthotopic liver transplantation

Objective To investigate the effects of ulinastatin on perioperative renal function in patients undergoing orthotopic liver transplantation (OLT) . Methods 40 patients receiving OTL were divided randomly into control group (group C, n = 20) and ulinastatin group (group U, n = 20). Ulinastatin group received intravenous infusion of ulinastatin 3 × 105 IU in 100 ml normal saline over 1 hour after skin incision, subsequently repeated every four hours up to 48 h after operation. Control group received same amount of normal saline instead of ulinastatin. Venous boold samples were taken before anesthesia (baseline), at the end of surgery (T1 ) and at 24 and 48h after operation (T2,3 ) for determination of serum nitrogen (BUN), and creatinine (Cr) concentrations. Urine specimens were taken for determination the levels of N-acetyl-beta-D-glucosaminidase ( NAG), γ-glutamyltranspeptidase (γ-GTP ) , α1 -microglobulin (α1 -MG ) , and retinal binding protein ( RBP) at T1-3 respectively. Results Before anesthesia there were no significant differences in all the parameters above between two groups ( P 0.05). Compared with the baseline values(T1), serum BUN and Cr concentrations at T2,3, and urine levels of γ-GTP, α,-MG, RBP and NAG at T1-3 significantly increased in group C; in group U urine α1-MG level at T1-3 and RBP level at T2,3 significantly increased( P 0.01 or 0.05), serum concentrations of BUN and Cr, urine levels of y-GTP and NAG unchanged significantly ( P 0.05) . Serum levels of BUN and Cr, urine α1 -MG level at T2,3, urine levels of y-GTP, RBP and NAG at T1-3 were significantly lower in group U than in group C ( P 0.01 or 0.05) .Conclusion Ulinastatin can protect perioperative renal function to some degree in patients undergoing OLT.