Reperfusion Injury Clinical Trial
Official title:
Does Pretreated Magnesium Protect Against Reperfusion Injury in Liver Transplanted Patients?
The purpose of this study is to evaluate the effect of intravenous magnesium infusion before reperfusion with employing some clinical parameters including blood lactate levels, because the intraoperative changes in the blood lactate levels after hepatic allograft reperfusion served as an accurate predictor of the initial graft function in living donor liver transplantation.
Clinically significant hemodynamic deterioration occurs immediately after reperfusion of the
grafted liver by unclamping of the portal vein. Profound hypotension, bradycardia, systemic
vasodilation, and a decrease in cardiac output have been reported, and this is described as
postreperfusion syndrome (PRS). This hemodynamic instability usually requires adequate and
aggressive cardiovascular pharmacologic management and fluid support, and recovers slowly
over a period of 30 to 60 minutes.Because the severity of PRS correlates with patient and
allograft outcome, prevention of its occurrence or attenuation of the hemodynamic changes
may improve outcome. However, not much is known about how to protect against this
reperfusion injury.
Reperfusion injury also occurs in myocardial infarction, ischemic spinal cord injury and
stroke. Recent experiments have shown protective effects of magnesium to reduce the
reperfusion injury of these conditions. Magnesium administration may provide cellular
protection during ischemia and reperfusion with stabilizing the cellular transmembrane
potential, suppressing excessive cellular calcium influx and energy demand.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Prevention
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