Document Detail


Erythropoietin ameliorates early ischemia-reperfusion injury following the Pringle maneuver.
MedLine Citation:
PMID:  20939113     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To investigate the protective effect of erythropoietin (Epo) against ischemia-reperfusion injury (IR/I) following the Pringle maneuver (PM), in comparison with conventional steroid administration in a prospective randomized trial.
METHODS: Patients were randomized by age, sex, diagnosis, and surgical method, and assigned to three groups: (1) A steroid group (STRD, n = 9) who received 100 mg of hydrocortisone before PM, and on postoperative days 1, 2 and 3, followed by tapering until postoperative day 7; (2) An EPO1 group (n = 10) who received 30,000 U of Epo before the PM and at the end of surgery; and (3) An EPO2 group (n = 8) who received 60,000 U of Epo before the PM. Hemoglobin (Hb), hematocrit (Ht), aspartate aminotransferase (AST), alanine transaminase (ALT), lactate dehydrogenase (LDH), lactate, interleukin-6 (IL-6), and tumor necrosis factor (TNF)-α were measured before and just after (Day 0) surgery, and on postoperative days 1, 3, 7 and 14.
RESULTS: There were no increases in Hb and Ht in the EPO1 and EPO2 groups. AST was significantly lower in EPO1 than in STRD on Day 0 (P = 0.041), and lower in EPO1 than in STRD and EPO2 on Day 1 (P = 0.018). ALT was significantly lower in EPO1 than in STRD and EPO2 on Day 0 (P = 0.020) and Day 1 (P = 0.004). There were no significant inter-group differences in the levels of LDH and lactate. IL-6 was significantly lower in EPO1 than in STRD and EPO2 on Day 0 (P = 0.0036) and Day 1 (P = 0.0451). TNF-α was significantly lower in EPO1 than in STRD and EPO2 on Day 0 (P = 0.0006) and Day 1 (P < 0.0001). Furthermore, hospitalization was significantly shorter in EPO1 and EPO2 than in STRD.
CONCLUSION: Epo has greater potential than steroids to ameliorate IR/I after the PM. Epo at a dose of 30,000 U, administered before PM and just after surgery, yields better results.
Authors:
Masato Kato; Tokihiko Sawada; Junji Kita; Mitsugi Shimoda; Keiichi Kubota
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Publication Detail:
Type:  Clinical Trial, Phase II; Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  16     ISSN:  2219-2840     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-12     Completed Date:  2011-01-28     Revised Date:  2014-05-20    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  4838-45     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Animals
Digestive System Surgical Procedures / adverse effects*
Erythropoietin / therapeutic use*
Female
Hematocrit
Hemoglobins / metabolism
Humans
L-Lactate Dehydrogenase / metabolism
Lactic Acid / metabolism
Length of Stay
Liver Diseases / surgery*
Male
Middle Aged
Prospective Studies
Reperfusion Injury / drug therapy*
Steroids / therapeutic use*
Tumor Necrosis Factor-alpha / metabolism
Chemical
Reg. No./Substance:
0/Hemoglobins; 0/Steroids; 0/Tumor Necrosis Factor-alpha; 11096-26-7/Erythropoietin; 33X04XA5AT/Lactic Acid; EC 1.1.1.27/L-Lactate Dehydrogenase
Comments/Corrections

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