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prostaglandin e1 administration post liver transplantation and renal outcomes:A retrospective single center experience

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World Journal of Transplantation 2024年第4期14卷 101-109页

作者： Vinay Jahagirdar Mohamed Ahmed Ifrah Fatima Hassam Ali Laura Alba John H Helzberg Lee S Cummings Matthew Wilkinson Jameson Forster Alisa Likhitsup Department of Internal Medicine Saint Luke’s Health System of Kansas City and the University of Missouri-Kansas CityKansas CityMO 64111United States Department of Gastroenterology and Hepatology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Division of Internal Medicine Department of Gastroenterology and HepatologySaint Luke’s Health System of Kansas City and University of Missouri-Kansas CityKansas CityMO 64111United States Department of Surgery University of Missouri-Kansas City and Transplant SurgerySaint Luke’s Hospital of Kansas CityKansas CityMO 64111United States Department of Gastroenterology and Hepatology University of MichiganAnn ArborMI 48109United States

BACKGROUND prostaglandin e1(PGe1),or alprostadil,is a potent vasodilator that improves hepatic blood flow and reduces ischemia-reperfusion injury post-liver transplantation(LT).However,the benefits of PGe1 on renal function after LT have not yet been well *** To assess the impact of PGe1 administration on renal function in patients who underwent liver or liver-kidney *** This retrospective study included all patients who underwent liver or liverkidney transplant at our institution from January,2011 to December,*** were classified based on whether they received ***1 was administered post-LT to those with transaminases>1000 U/L in the immediate postoperative ***,post-LT treatments and/or complications,renal function,and survival were *** logistic regression analysis was performed,and a two-tailed P valueered statistically *** A total of 145 patients underwent LT,with 44(30%)receiving *** patient characteristics were comparable,except the PGe1 group had significantly higher aspartate aminotransferase(AST)(1961.9 U/L±1862.3 U/L vs 878 U/L±741.4 U/L,P=0.000),alanine aminotransferase(1070.6 U/L±895 U/L vs 547.7 U/L±410 U/L,P=0.000),international normalized ratio on post-LT day 1(2±0.74 vs 1.8±0.4,P=0.03),a longer intensive care unit stay(8.1 days±11.8 days vs 3.8 days±4.6 days,P=0.003),more vasopressor use(55.53 hours±111 hours vs 16.33 hours±26.3 hours,P=0.002),and higher immediate postoperative complications(18.6%vs 4.9%,P=0.04).The PGe1 group also had a significantly higher 90-day readmission rate(29.6%vs 13.1%,P=0.02)and lower 1-year liver graft survival(87.5%vs 98.9%,P=0.005).However,30-day readmission(31.6%vs 27.4%,P=0.64),LT complications(hepatic artery thrombosis,biliary complications,rejection of liver graft,cardiomyopathy),1-year patient survival(96.9%vs 97.8%,P=0.77),overall liver graft survival,and overall patient survival were similar between t

关键词： Liver transplantation Alprostadil Protective agents Transplant prostaglandin e1

Protective effects of prostaglandin e1 perfusion againstspinal cord ischemia-reperfusion injury in a rabbit model

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Neural Regeneration Research 2008年第6期3卷 659-662页

作者： Xifan Mei Yansong Wang Chang Liu Department of Orthopaedics the First Affiliated Hospital of Liaoning Medical University Jinzhou 121000 Liaoning Province China emergency Department the First Affiliated Hospital of Liaoning Medical University Jinzhou 121000 Liaoning Province China Department of endocrinology the First Affiliated Hospital of Liaoning Medical University Jinzhou 121000 Liaoning Province China

BACKGROUND： prostaglandin e1 （PGe1） is known to be protective in ischemia-reperfusion of heart, lung,renal, and liver tissue. It still remains to be determined whether PGe1 exhibits similar protection against spinal cord ischemia-reperfusion injury in a rabbit model. OBJeCTIVe： To observe the large, ventral horn, motor neurons of the spinal cord, as well as limb function, and to investigate whether perfusion of PGe1 exhibits protective effects against spinal cord ischemia-reperfusion injury in a rabbit model. DeSIGN, TIMe AND SeTTING： Controlled observation. The experiment was performed at the Department of Orthopedics, First Affiliated Hospital of Liaoning Medical University between June and October 2007. MATeRIALS： Twenty male, New Zealand white rabbits, weighing 2.0 kg and of mixed gender, were used in the present study. The following chemicals and compounds were used： prostaglandin e1 injectable powder,as well as malondialdehyde and ATPase kits. Animal intervention was in accordance with animal ethical standards. MeTHODS： We separated rabbits into control and experimental groups randomly, with 10 rabbits in each group. Rabbits were used as spinal cord ischemia models by segmentally cross-clamping the infrarenal aorta. The control group was subsequently perfused for five minutes with blood and saline solution, and the experimental group was perfused for 5 minutes with blood and saline solution containing PGe1 （100 ng/kg/min）. MAIN OUTCOMe MeASUReS： The neurological function of the hind limbs was assessed 12, 24, and 48 hours after model establishment. All animals were sacrificed and spinal cords were harvested for histological analyses. The large motor neurons in the ventral horn of L1-7 were observed by inverted microscope. ReSULTS： All 20 rabbits were included in the final analysis, without any loss. In the ventral horn of the L5-7 segments, there were more large motor neurons that appeared viable in the experimental group than the control group （P 〈 0.05）. The

关键词： prostaglandin e1 spinal cord ischemia-reperfusion neuron

Intra-arterial lipo-prostaglandin e1 infusion for arterial spasm in liver transplantation:A case report

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World Journal of Clinical Cases 2023年第34期11卷 8153-8157页

作者： Moonhwan Kim Hae Won Lee Chang Jin Yoon Boram Lee Yeongsoo Jo Jai Young Cho Yoo-Seok Yoon Jun Suh Lee Ho-Seong Han Department of Surgery Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnam-si 13620Gyeonggi-doSouth Korea Department of Radiology Seoul National UniversitySeongnam 463-707South Korea

BACKGROUND Hepatic artery obstruction is a critical consideration in graft outcomes after living donor liver *** report a case of diffuse arterial vasospasm that developed immediately after anastomosis and was managed with an intra-arterial infusion of lipo-prostaglandin e1(PGe1).CASe SUMMARY A 57-year-old male with hepatitis B virus-related liver cirrhosis and hepatocellular carcinoma underwent ABO-incompatible living donor liver *** grafted hepatic artery was first anastomosed to the recipient’s right hepatic artery ***,the arterial pulse immediately *** a new anastomosis was performed using the right gastroepiploic artery,the patient’s arterial pulse rate remained *** attempted angiographic intervention immediately after the operation;it showed diffuse arterial vasospasms like‘beads on a string’.We attempted continuous infusion of lipo-PGe1 overnight via an intra-arterial *** next day,arterial flow improved without any spasms or *** patient had no additional arterial complications or related sequelae at the time of writing,1-year post-liver *** Angiographic evaluation is helpful in cases of repetitive arterial obstruction,and intra-arterial infusion of lipo-PGe1 may be effective in treating diffuse arterial spasms.

关键词： Liver transplantation Hepatic artery Vasospasm prostaglandin e1 Intervention Case report

eFFeCTS OF prostaglandin e1 ON THe PROGReSSION OF ARISTOLOCHIC ACID NePHROPATHY

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Chinese Medical Sciences Journal 2005年第1期20卷 67-69,页

作者： DongSun Jiang-minFeng Yan-lingZhao TaoJin Li-ningWang DepartmentofNephropathy theFirstAffiliatedHospitalChinaMedicalUniversityShenyang110001

Objective To investigate the effects of prostaglandin e1 (PGe1) on the progression of aristolochic acid nephropathy (AAN). Methods Twenty-four patients diagnosed as AAN with serum creatinine (Scr) between 1.5 mg/dL and 4 mg/dL during September 2001 to August 2003 were randomly divided into 2 groups. All patients had ingested long dan xie gan wan con-taining aristolochic acid (0.219 mg/g) for at least 3 months. Twelve patients were injected with Alprostadil (10 μg/d for 10 days in one month, summing up to 6 months). except for PGe1, the other therapy was same in both groups. Renal function was assessed using reciprocal serum creatinine levels (1/Scr). Results The level of Scr and serum hemoglobin (Hgb) was similar in both groups prior to therapy. During follow-up, 1/Scr levels in PGe1 group were significantly higher than control group (P 1), and Hgb levels in PGe1 group were sig-nificantly increased compared with control (P e1 can slow the progression of renal failure and increase Hgb level of AAN patient.

关键词： prostaglandin e1 aristolochic acid nephropathy serum creatinine hemoglobin

Does perioperative prostaglandin e1 affect survival of patients with esophageal cancer?

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World Journal of Gastrointestinal Surgery 2012年第12期4卷 284-288页

作者： Fahimeh Farrokhnia Jalil Makarem Habibollah Mahmoodzadeh Nazanin Andalib Department of Anesthesiology the Cancer Institute Imam Khomeini Medical Center Tehran University of Medical Sciences Tehran 15614 Iran Department of Anesthesiology and Intensive Care Imam Khomeini Medical Center Tehran University of Medical Sciences Tehran 15614 Iran Department of Surgery the Cancer Institute Imam Khomeini Medical Center Tehran University of Medical Sciences Tehran 15614 Iran School of Biology Campus of Science University of Tehran Tehran Iran

AIM: To detect the effect of intraoperative prostaglandin e1 (PGe1) infusion on survival of esophagectomized patients due to cancer. MeTHODS: In this preliminary study, a double blinded placebo based clinical trial was performed. Thirty patients with esophageal cancer scheduled for esophagectomy via the transthoracic approach were randomized by a block randomization method, in two equal groups: PGe1 group - infusion of PGe1 (20 ng/kg per minute) in the operating room and placebo group - saline 0.9% with the same volume and rate. The infusion began before induction of anesthesia and finished just before transfer to the intensive care unit. The patients, anesthetist, intensive care physicians, nurses and surgeons were blinded to both study groups. All the patients were anesthetized with the same method. For postoperative pain control, a thoracic epidural catheter was placed for all patients before induction of anesthesia. We followed up the patients until October 2010. Basic characteristics, duration of anesthesia, total surgery and thoracotomy time, preoperative hemoglobin, length of tumor, grade of histological differentiation, disease stage, number of lymph nodes in the resected mass, number of readmissions to hospital, total duration of readmission and survival rates were compared between the two groups. Some of the data originates from the historical data reported in our previous study. We report them for better realization of the follow up results. ReSULTS: The patients’ characteristics and perioperative variables were compared between the two groups. There were no significant differences in age (P = 0.48), gender (P = 0.27), body mass index (P = 0.77), American Society of Anesthesiologists physical status more than?I?(P = 0.71), and smoking (P = 0.65). The PGe1 and placebo group were comparable in the following variables: duration of anesthesia (277 ± 50 vs 270 ± 67, P = 0.86), duration of thoracotomy (89 ± 35 vs 96 ± 19, P = 0.46), duration of operation (234 ±

关键词： prostaglandin e1 esophagectomy Cancer Survival Surgery

effects of prostaglandin e1 plus methylcobalamin alone and in combination with lipoic acid on nerve conduction velocity in patients with diabetic peripheral neuropathy:a meta-analysis

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Effects of prostaglandin E1 plus methylcobalamin alone and i...

efficacy and safety of prostaglandin e1 plus lipoic acid combination therapy versus monotherapy for patients with diabetic peripheral neuropathy:a meta-analysis

2016年广东省药师周大会

作者： De-Qi Jiang Ming-Xing Li Yan Wang Yong Wang Department of Pharmacy Zhujiang Hospital of Southern Medical University Department of Biopharmaceutical Yulin Normal University

This report was to evaluate the efficacy of lipoic acid,prostaglandin e1 and methylcobalamin(L+P+M) for the treatment of diabetic peripheral neuropathy(DPN) in comparison with that of prostaglandin e1 plus methylcobalamin(P+M),in order to provide the basis and reference for clinical rational drug *** controlled trials(RCTs) of L+P+M for DPN published up to August 3,2014 were searched.A random or fixed effect model was used to analyse outcomes which were expressed as risk ratios(RRs) or mean difference(MD) with a 95% confidence interval(CI).eighteen RCTs with 1,410 participants were *** efficacy of L+P+M therapy was significantly better than P+M therapy(fifteen trials;RR 1.32,95% CI 1.24 to 1.41,P1,2=32%).Compared with P+M therapy,the pooled effects of L+P+M therapy on nerve conduction velocities(NCVs) were(fifteen trials;MD 4.70,95% CI 3.77 to 5.63,P1,2=79%) for median MNCV,(thirteen trials;MD 4.73,95% CI 3.69 to 5.77,P1,2=85%) for median SNCV,(sixteen trials;MD 4.22,95% CI 3.32 to 5.12,P1,2=83%) for peroneal MNCV,(fourteen trials;MD 3.09,95% CI 2.04 to 4.14,P1,2=82%) for peroneal *** were no serious adverse events associated with drugs intervention.L+P+M therapy was superior to P+M therapy for improvement of clinical efficacy and NCVs in *** findings should be further verified by high-quality RCTs.

关键词： diabetic peripheral neuropathy lipoic acid prostaglandin e1 methylcobalamin nerve conduction velocity meta-analysis

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Efficacy and safety of prostaglandin E1 plus lipoic acid com...

The effect of prostaglandin e_1 on recovery of early renal graft functions after transplantation

2017年广东省药师周大会

作者： De-Qi Jiang Ming-Xing Li Yan-Jiao Ma Yan Wang Yong Wang Department of Pharmacy Zhujiang Hospital of Southern Medical University Cultivation Base for Key Laboratory of Conservation and Utilization of Rare and economic Species at Southeast Guangxi Yulin Normal University Department of Biopharmaceutical School of Life Science and TechnologyYulin Normal University

The aim of this report was to evaluate the efficacy and safety of prostaglandin e1(PGe1) plus lipoic acid(LA) for the treatment of diabetic peripheral neuropathy(DPN) compared with that of PGe1 or LA monotherapy, in order to provide the basis and reference for clinical rational drug use. Randomized controlled trials(RCTs) published up to August 3, 2014 were searched. A random or fixed effect model was used to analyse outcomes expressed as risk ratios(RRs) or mean difference(MD) with a 95% confidence interval(CI). I2 statistic was used to assess heterogeneity. Subgroup and sensitivity analyses were performed. The outcomes measured were as follows: the clinical efficacy, median motor nerve conduction velocity(MNCV), median sensory nerve conduction velocity(SNCV), peroneal MNCV, peroneal SNCV and adverse effects. Thirty-one RCTs with 2676 participants were included. Clinical efficacy of PGe1+LA combination therapy was significantly better than monotherapy(p 1, RR=1.32, 95% CI 1.26 to 1.38). Compared with monotherapy, PGe1+LA combination therapy led to significant improvements in median MNCV(p 1, MD=4.69, 95% CI 3.16 to 6.23), median SNCV(p 1, MD=5.46, 95% CI 4.04 to 6.88), peroneal MNCV(p 1, MD=5.19, 95% CI 3.71 to 6.67) and peroneal SNCV(p 1, MD=5.50, 95% CI 3.30 to 7.70). There were no serious adverse events associated with drug intervention. PGe1 plus LA combination therapy is superior to PGe1 or LA monotherapy for improvement of neuropathic symptoms and nerve conduction velocities in patients with DPN. These findings should be further validated by larger well-designed or high-quality RCTs.

关键词： diabetic peripheral neuropathy prostaglandin e1 lipoic acid efficacy meta-analysis

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Journal of Pharmaceutical Analysis 2008年第4期20卷 221-224页

作者：宋焕瑾薛武军田晓辉李杨丁晨光丁小明冯新顺靳占魁 Center of Nephropathy the First Affiliated Hospital Medical School of Xi'an Jiaotong University

Objective To investigate the effect of prostaglandin e1 (PGe1) on recovery of early renal graft functions after transplantation. Methods One hundred and seven patients after renal transplantation were allocated in the treated group, and treated by conventional treatment with injection of 10 μg prostaglandin e1 additionally twice a day for 14 days. And eighty-eight patients who received conventional treatment alone after renal transplantation at the corresponding period were allocated in the control group. Indexes of the two groups, including incidence of delayed graft function and acute rejection reaction, volume of urine, serum certaintie (SCr), endogenous certainties clearance rate (CCr), the blood flow resistance in graft as well as blood viscosity (BV), and platelet aggregation rate (PAR), were determined. Results The urinary volume and endogenous certainties clearance rate of the treated group were significantly higher, but the level of SCr, incidence of renal function recovery retardation, BV, PAR and blood flow resistance in graft were significantly lower than those of the control group (Pe difference of incidence of acute rejection reaction between the two groups was insignificant (P>0.05). Conclusion prostaglandin e1 can improve blood microcirculation and decrease the incidence of renal function recovery retardation. These effects are helpful for recovery of renal function after renal transplantation.

关键词： renal transplantation prostaglandin e1 allograft renal function

前列腺素e1对原发性肾病综合征作用初探(英文)

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中国医学工程 2002年第6期10卷 37-39页

作者：周巧玲成小苗欧阳春解勤之陈立平胡杨清中南大学湘雅医院肾内科长沙410008

Objective:To investigate the effect of prostaglandin e1 (PGe1) (Alprostadii injection) on patients with primary nephrotic syndrome(PNS). Methods: 37 patients with PNS were recruited to study the effect of prostaglandin e1 on platelet aggregation function [ PAG (5,) PAG( m ) ], serum total protein (TP) , albumin (Al),blood urea nitrogen(BUN) ,serum creatinine(Scr) ,cholesterol(CHO), triglyceride(TG), protein in 24-hour urine (Pr/24h) and platelet account (PLT). Results: TP, Al, CHO, TG, BUN, Scr, Pr/24h, PAG(5) and PAG(m) in PNS group before treatment were significantly different from those in control group(P＜0.05, P＜0.01) while no significant difference was found for PLT. When treated with PGe1 , TP,Al,CHO, TG, Pr/24h, ADP- induced PAG(5) ,and Adr- induced PAG(5) and PAG(m) were significantly different from those before treatment (P＜0.05). Adr- induced PAG(5) and PAG(m) were significantly different. Adr- induced PAG(5) was xsitively correlated with BUN and Scr in PNS(P＜0.01). Similar correlation was found between ADP-induced PAG(5) and Al ,BUN,Scr,Pr/24h(P＜0.05), AD- induced PAG(m) and TP,CHO(P＜0.05). Conclusions: PGe1 may be an effective drug for the treatment for hypercoagulation in patients with PNS.

关键词： Primary Nephrotic Syndrome prostaglandin e1 Platelet Aggregation Function