{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T21:20:53Z","timestamp":1776115253786,"version":"3.50.1"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2017,6,29]],"date-time":"2017-06-29T00:00:00Z","timestamp":1498694400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2017,6,29]],"date-time":"2017-06-29T00:00:00Z","timestamp":1498694400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:p>Perioperative terlipressin (Tp) during living donor liver transplantation (LDLT) has been shown to reduce intraoperative portal pressures and improve renal function. Its role and safety profile have never been evaluated in a double\u2010blind randomized controlled trial (RCT). The aim was to evaluate the hemodynamic effects, clinical benefits, and safety of perioperative Tp infusion in adult LDLT. This was a single\u2010center double\u2010blind RCT. Consenting adults with chronic liver disease and low risk of posttransplant renal dysfunction undergoing their first LDLT were randomized. The study group (terlipressin group [TpG]) received an initial bolus of Tp during surgery followed by a Tp infusion for 72 hours in the postoperative period. The placebo group (PbG) received a saline infusion. The primary endpoint was portal pressure after arterial reperfusion. Multiple intraoperative and postoperative variables served as secondary endpoints. A total of 41 patients were enrolled in the trial (TpG, 21; PbG, 20). There were no significant differences in intraoperative portal pressures, blood loss, fluid requirement, vasopressor requirement, or urine output. Peak intraoperative and end of surgery lactate levels were significantly higher in the Tp group. There was no difference in postoperative liver function tests. Incidence of acute kidney injury as assessed by Risk, Injury, Failure, Loss, and End\u2010Stage Kidney Disease criteria was lower in the Tp group (27% versus 60%; <jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.04). The TpG had less postoperative ascites, a lower need for percutaneous interventions, and a shorter hospital stay. Incidence of bradycardia requiring pharmacological intervention and withdrawal from study was significantly higher in the TpG. In conclusion, this study has not demonstrated a reduction in postreperfusion portal pressure with Tp. However, Tp infusion reduced postoperative ascitic drain output resulting in less frequent percutaneous interventions and reduced hospital stay. Intraoperative hyperlactatemia and symptomatic bradycardia are major concerns. Its use should be restricted to patients with high\u2010volume ascites, and it needs close monitoring during drug infusion. <jats:italic toggle=\"yes\">Liver Transplantation 23 1007\u20131014 2017<\/jats:italic> AASLD.<\/jats:p>","DOI":"10.1002\/lt.24759","type":"journal-article","created":{"date-parts":[[2017,3,14]],"date-time":"2017-03-14T21:10:57Z","timestamp":1489525857000},"page":"1007-1014","source":"Crossref","is-referenced-by-count":32,"title":["Double\u2010blind randomized controlled trial of the routine perioperative use of terlipressin in adult living donor liver transplantation"],"prefix":"10.1097","volume":"23","author":[{"given":"Mettu Srinivas","family":"Reddy","sequence":"first","affiliation":[{"name":"Institute of Liver Disease and Transplantation, Global Hospital,Chennai,India"},{"name":"National Foundation for Liver Research,Chennai,India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilankumaran","family":"Kaliamoorthy","sequence":"additional","affiliation":[{"name":"Department of Liver Anesthesia and Intensive Care,Global Hospital,Chennai,India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akila","family":"Rajakumar","sequence":"additional","affiliation":[{"name":"Department of Liver Anesthesia and Intensive Care,Global Hospital,Chennai,India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selvakumar","family":"Malleeshwaran","sequence":"additional","affiliation":[{"name":"Department of Liver Anesthesia and Intensive Care,Global Hospital,Chennai,India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellango","family":"Appuswamy","sequence":"additional","affiliation":[{"name":"Department of Liver Anesthesia and Intensive Care,Global Hospital,Chennai,India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sukanya","family":"Lakshmi","sequence":"additional","affiliation":[{"name":"Institute of Liver Disease and Transplantation, Global Hospital,Chennai,India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joy","family":"Varghese","sequence":"additional","affiliation":[{"name":"Institute of Liver Disease and Transplantation, Global Hospital,Chennai,India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Rela","sequence":"additional","affiliation":[{"name":"Institute of Liver Disease and Transplantation, Global Hospital,Chennai,India"},{"name":"National Foundation for Liver Research,Chennai,India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2017,6,29]]},"reference":[{"key":"lt24759-bib-0001-20240122","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1034\/j.1600-0676.2000.020001051.x","article-title":"Central and systemic haemodynamic effects of terlipressin in portal hypertensive patients","volume":"20","year":"2000","journal-title":"Liver"},{"key":"lt24759-bib-0002-20240122","first-page":"CD002147","article-title":"Terlipressin for acute esophageal variceal hemorrhage","volume":"1","year":"2003","journal-title":"Cochrane Database Syst Rev"},{"key":"lt24759-bib-0003-20240122","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1053\/j.gastro.2008.02.014","article-title":"A randomized, prospective, double\u2010blind, placebo\u2010controlled trial of terlipressin for type 1 hepatorenal 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