Literature DB >> 23736923

Ulinastatin, a protease inhibitor, may inhibit allogeneic blood transfusion-associated pro-inflammatory cytokines and systemic inflammatory response syndrome and improve postoperative recovery.

Haihua Shu1, Kuanzhi Liu1, Qiulan He1, Fei Zhong2, Lu Yang1, Qiaobo Li1, Weifeng Liu1, Fang Ye1, Wenqi Huang1.   

Abstract

BACKGROUND: The aim of this study was to investigate the effects of ulinastatin, a protease inhibitor, and blood transfusion on perioperative surgical complications, changes of systemic inflammatory response syndrome (SIRS) scores, and levels of interleukin-6 (IL-6), interleukin-8 (IL-8) and tumour necrosis factor-α (TNF-α) in patients undergoing liver resection.
MATERIALS AND METHODS: Patients aged 18-65 years were enrolled and divided into four groups (12 patients in each group): a control group, a group given ulinastatin (UTI group), a group given blood transfusion (BT group), and a group given both blood transfusion and ulinastatin (BT+UTI group). Patients were randomised to receive ulinastatin or not, whereas blood transfusion was administered based on a transfusion trigger. Ulinastatin was given at a dose of 100,000 units/10 kg, infused 15 min before allogeneic blood transfusion or after completion of the liver resection. The patients were followed up for 3 days to record surgical complications, SIRS scores and levels of IL-6, IL-8 and TNF-α.
RESULTS: Forty-four patients were included in the data analysis. The SIRS rate (SIRS scores≥2) was significantly higher in the BT groups than in the control group at 6 hours and on day 3 after surgery and was significantly lower in the BT+UTI group than in the BT group on day 3 after surgery. Allogeneic blood transfusion significantly increased and ulinastatin significantly decreased postoperative levels of IL-6, IL-8, and TNF-α. The length of stay in hospital was significantly longer in the BT groups than in the control group but was not significantly different between the BT+UTI and BT groups.
CONCLUSION: A single dose of ulinastatin before allogeneic blood transfusion may lower the rate of postoperative SIRS and levels of IL-6, IL-8 and TNF-α associated with allogeneic blood transfusion and improve patients' postoperative recovery.

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Year:  2013        PMID: 23736923      PMCID: PMC3934215          DOI: 10.2450/2013.0224-12

Source DB:  PubMed          Journal:  Blood Transfus        ISSN: 1723-2007            Impact factor:   3.443


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