Effects of different doses of ulinastatin on liver function during and after orthotopic liver transplantation

Objective To evaluate the effects of different doses of ulinastatin on liver function during and after operation in adult patients undergoing orthotopic liver transplantation (OLT).Methods Sixty ASAⅡorⅢpatients with end-stage liver disease (42 male,18 female) aged 29-68 yrs weighing 48-86 kg were included in this study.Patients with toxemia,hepatic coma or tachycardia (HR＞120 bpm) were excluded.The patients were randomly divided into 4 groups (n=15 each).In the 3 ulinastatin groups ulinastatin was infused continuously after operation was started at 5×10~4 U·h~(-1)(U_1 group) or 1×10~5 U·h~(-1)(U_2 group) or 2×10~5 U·h~(-1) (U_3 group), while in control group normal saline was infused instead of ulinastatin.Radial artery was cannulated and Swan-Ganz catheter was placed via internal jugular vein.Venous blood samples were taken before skin incision (T_1,baseline) at 30,90,180 rain of neohepatic phase (T_(2.3.4)) and 24 h after operation (T_5) for evaluation of liver function. ALT,AST,GGT,ALP and LDH levels were measured.Results There was no significant difference in the ALT, AST,GGT,ALP and LDH levels among the 4 groups at T_1 before skin incision.ALT,AST,GGT,ALP and LDH were significantly increased during neohepatic phase as compared to the baseline values at T_1 in all 4 groups,but the degree of increase was significantly lower in group U_2 and U_3.Conclusion Intraoperative continuous infusion of ulinastatin at 1×10~5-2×10~5 U·h~(-1) can inhibit the increase in ALT,AST,GGT,ALP and LDH dose- dependently after reperfusion of the graft.