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Effect of dexmedetomidine on liver transplantation: a meta-analysis

Background: Dexmedetomidine (DEX), an adjuvant anesthetic, may improve the clinical outcomes of liver transplantation (LT). Methods: We summarized the relevant clinical trials of DEX in patients undergoing LT. As of 30 January 2023, we searched The Cochrane Library, MEDLINE, EMBASE, Clinical Trial.g...

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Autores principales: Jia, Degong, Guo, Shanshan, Wu, Xinyi, Zhao, Minjie, Luo, Jiefu, Cheng, Mingxiang, Qin, Yajun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10245273/
https://www.ncbi.nlm.nih.gov/pubmed/37292152
http://dx.doi.org/10.3389/fphar.2023.1188011
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author Jia, Degong
Guo, Shanshan
Wu, Xinyi
Zhao, Minjie
Luo, Jiefu
Cheng, Mingxiang
Qin, Yajun
author_facet Jia, Degong
Guo, Shanshan
Wu, Xinyi
Zhao, Minjie
Luo, Jiefu
Cheng, Mingxiang
Qin, Yajun
author_sort Jia, Degong
collection PubMed
description Background: Dexmedetomidine (DEX), an adjuvant anesthetic, may improve the clinical outcomes of liver transplantation (LT). Methods: We summarized the relevant clinical trials of DEX in patients undergoing LT. As of 30 January 2023, we searched The Cochrane Library, MEDLINE, EMBASE, Clinical Trial.gov and the WHO ICTRP. The main outcomes were postoperative liver and renal function. The random effect model or fixed effect model was used to summarize the outcomes across centers based on the differences in heterogeneity. Results: The meta-analysis included nine studies in total. Compared with the control group, the DEX group had a reduced warm ischemia time (MD-4.39; 95% CI-6.74−‐2.05), improved postoperative liver (peak aspartate transferase: MD-75.77, 95% CI-112.81−‐38.73; peak alanine transferase: MD-133.51, 95% CI-235.57−‐31.45) and renal function (peak creatinine: MD-8.35, 95% CI-14.89−‐1.80), and a reduced risk of moderate-to-extreme liver ischemia-reperfusion injury (OR 0.28, 95% CI 0.14-0.60). Finally, the hospital stay of these patients was decreased (MD-2.28, 95% CI-4.00−‐0.56). Subgroup analysis of prospective studies showed that DEX may have better efficacy in living donors and adult recipients. Conclusion: DEX can improve short-term clinical outcomes and shorten the hospital stay of patients. However, the long-term efficacy of DEX and its interfering factors deserves further study. Systematic Review: identifier CRD42022351664.
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spelling pubmed-102452732023-06-08 Effect of dexmedetomidine on liver transplantation: a meta-analysis Jia, Degong Guo, Shanshan Wu, Xinyi Zhao, Minjie Luo, Jiefu Cheng, Mingxiang Qin, Yajun Front Pharmacol Pharmacology Background: Dexmedetomidine (DEX), an adjuvant anesthetic, may improve the clinical outcomes of liver transplantation (LT). Methods: We summarized the relevant clinical trials of DEX in patients undergoing LT. As of 30 January 2023, we searched The Cochrane Library, MEDLINE, EMBASE, Clinical Trial.gov and the WHO ICTRP. The main outcomes were postoperative liver and renal function. The random effect model or fixed effect model was used to summarize the outcomes across centers based on the differences in heterogeneity. Results: The meta-analysis included nine studies in total. Compared with the control group, the DEX group had a reduced warm ischemia time (MD-4.39; 95% CI-6.74−‐2.05), improved postoperative liver (peak aspartate transferase: MD-75.77, 95% CI-112.81−‐38.73; peak alanine transferase: MD-133.51, 95% CI-235.57−‐31.45) and renal function (peak creatinine: MD-8.35, 95% CI-14.89−‐1.80), and a reduced risk of moderate-to-extreme liver ischemia-reperfusion injury (OR 0.28, 95% CI 0.14-0.60). Finally, the hospital stay of these patients was decreased (MD-2.28, 95% CI-4.00−‐0.56). Subgroup analysis of prospective studies showed that DEX may have better efficacy in living donors and adult recipients. Conclusion: DEX can improve short-term clinical outcomes and shorten the hospital stay of patients. However, the long-term efficacy of DEX and its interfering factors deserves further study. Systematic Review: identifier CRD42022351664. Frontiers Media S.A. 2023-05-22 /pmc/articles/PMC10245273/ /pubmed/37292152 http://dx.doi.org/10.3389/fphar.2023.1188011 Text en Copyright © 2023 Jia, Guo, Wu, Zhao, Luo, Cheng and Qin. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Jia, Degong
Guo, Shanshan
Wu, Xinyi
Zhao, Minjie
Luo, Jiefu
Cheng, Mingxiang
Qin, Yajun
Effect of dexmedetomidine on liver transplantation: a meta-analysis
title Effect of dexmedetomidine on liver transplantation: a meta-analysis
title_full Effect of dexmedetomidine on liver transplantation: a meta-analysis
title_fullStr Effect of dexmedetomidine on liver transplantation: a meta-analysis
title_full_unstemmed Effect of dexmedetomidine on liver transplantation: a meta-analysis
title_short Effect of dexmedetomidine on liver transplantation: a meta-analysis
title_sort effect of dexmedetomidine on liver transplantation: a meta-analysis
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10245273/
https://www.ncbi.nlm.nih.gov/pubmed/37292152
http://dx.doi.org/10.3389/fphar.2023.1188011
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