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Effects of Pre-Transplant L-Carnitine Supplementation on Primary Graft Dysfunction in Liver Transplant Recipients: A Pilot, Randomized, Placebo-Controlled Clinical Trial Publisher



Khajeh B1 ; Dashtikhavidaki S1, 2 ; Nasiritoosi M2 ; Mohammadi K1 ; Jafari A3
Authors
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Authors Affiliations
  1. 1. Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Liver Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Clinical Pharmacy, Faculty of Pharmacy, Guilan University of Medical Sciences, Rasht, Iran

Source: Research in Pharmaceutical Sciences Published:2019


Abstract

Primary graft dysfunction (PGD) and non-function (PNF) happen in 8.7-24.7% and 0.9-7.2% of liver transplant recipients, respectively. These phenomena increase treatment cost and patients' death. This study assessed the effect of L-carnitine supplementation on the incidences of PNF/PGD in liver transplant recipients. This randomized, placebo-controlled, clinical trial was performed on adult liver transplant recipients. Patients took L-carnitine syrup 500 mg three times daily or placebo from the time of including in transplant waiting list until the day of transplant surgery (median 14 days, 1-192 days). Thirty-three patients in L-carnitine and 39 patients in placebo group completed the study. Although not statistically significant, PNF and PGD happened less frequently among recipients in L-carnitine compared with placebo group (3% vs. 12.8% for PNF; 15.2% vs. 30.8% for PGD). Alanine aminotransferase (ALT) and aspartate aminotransferase were lower in L-carnitine group at day 3 after transplantation. ALT declined more significantly within 48 h after transplantation in L-carnitine arm (median 120.50 vs. 79 IU/L; P = 0.03). One-month patients' survival was significantly higher in L-carnitine versus placebo group (97% vs. 74.4%; P = 0.008). The rates of PNF and PGD in L-carnitine group were approximately one-fourth and one-half of placebo group respectively. One-month patients' survival was higher in L-carnitine group. © 2019 Wolters Kluwer Medknow Publications. All rights reserved.