首页|Liver-protecting effects of omega-3 fish oil lipid emulsion in liver transplantation
Liver-protecting effects of omega-3 fish oil lipid emulsion in liver transplantation
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NETL
NSTL
万方数据
维普
AIM:To investigate the liver-protecting effect of parenteral nutrition (PN) support with omega-3 fatty acids in a randomized controlled clinical trial.METHODS:Sixty-six patients with the diagnosis of end-stage liver disease or hepatic cellular carcinoma were admitted to the Affiliated Drum Tower Hospital,Nanjing University,China for orthotopic liver transplantation.The patients were randomly divided into two groups:PN group (n =33) and polyunsaturated fatty acid (PUFA) group (n =33).All patients received isocaloric and isonitrogenous PN for seven days after surgery,and in PUFA group omega-3 fish oil lipid emulsion replaced part of the standard lipid emulsion.Liver function was tested on days 2 and 9 after surgery.Pathological examination was performed after reperfusion of the donor liver and on day 9.Clinical outcome was assessed based on the post-transplant investigations,including:(1) post-transplant mechanical ventilation; (2) total hospital stay; (3) infectious morbidities; (4) acute and chronic rejection; and (5) mortality (intensive care unit mortality,hospital mortality,28-d mortality,and survival at a one-year post-transplant surveillance period).RESULTS:On days 2 and 9 after operation,a significant decrease of alanine aminotransferase (299.16U/L ± 189.17 U/L vs 246.16 U/L ±175.21 U/L,P =0.024) and prothrombin time (5.64 s ± 2.06 s vs 2.54s ± 1.15 s,P =0.035) was seen in PUFA group compared with PN group.The pathological results showed that omega-3 fatty acid supplement improved the injury of hepatic cells.Compared with PN group,there was a significant decrease of post-transplant hospital stay in PUFA group (18.7 d ± 4.0 d vs 20.6 d ± 4.6d,P =0.041).Complications of infection occurred in 6 cases of PN group (2 cases of pneumonia,3 cases of intra-abdominal abscess and 1 case of urinary tract infection),and in 3 cases of PUFA group (2 cases of pneumonia and 1 case of intra-abdominal abscess).No acute or chronic rejection and hospital mortality were found in both groups.The one-year mortality in PN group was 9.1％ (3/33),one died of pulmonary infection,one died of severe intra-hepatic cholangitis and hepatic dysfunction and the other died of hepatic cell carcinoma recurrence.Only one patient in PUFA group (1/33,3.1％) died of biliary complication and hepatic dysfunction during follow-up.CONCLUSION:Post-transplant parenteral nutritional support combined with omega-3 fatty acids can significantly improve the liver injury,reduce the infectious morbidities,and shorten the post-transplant hospital stay.
Fish oil lipidLiverTransplantationParenteral nutritionMetabolism
NETL
NSTL
万方数据
维普
