Renal hemodynamics, urinary eicosanoids, and endothelin after liver transplantation

Stephen C Textor, D. J. Wilson, Amir Lerman, J. C. Romero, John C Jr. Burnett, R. Wiesner, E. R. Dickson, R. A F Krom

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Patients with hepatic cirrhosis develop widespread abnormalities in kidney function and vasoactive hormones. These change rapidly after liver transplantation during immunosuppression with cyclosporine. The role of changing eicosanoid excretion and endothelin levels in regulating renal function after transplantation in humans remains uncertain. We studied 32 patients with regard to renal hemodynamics, glomerular filtration, urinary prostacyclin (6-keto-PG-F1-alpha), thromboxane (TBX2), and endothelin before and during the first four weeks after orthotopic liver transplantation. Arterial pressure rose from 106±2/61±2 to 146±4/81±2 mmHg, (P<.001), while renal blood flow fell (686±38 to 453±24 ml/min/1.73 m2, P<.05), as did GFR. Pretransplant excretion of 6-keto and TBX2 was above that of normal subjects and fell progressively after transplant, as did plasma renin activity and aldosterone. The 6-keto levels fell below normal after two weeks. The ratio of TBX2/6-keto remained elevated compared with normal subjects throughout the month after transplant (1.54±0.38 vs. 0.54±0.07, P<.01). Endothelin levels rose during the first week (7.4±1.4 vs. 12.4±2.7 pg/ml, P<.05), but fell back to baseline thereafter. These results indicate that high levels of urinary eicosanoids in patients with liver disease fall rapidly after liver transplantation during CsA immunosuppression. Unlike results in many experimental models, these data suggest that renal vasoconstriction in humans may be associated primarily with suppression in renal prostacyclin excretion rather than stimulation of thromboxane.

Original languageEnglish (US)
Pages (from-to)74-80
Number of pages7
JournalTransplantation
Volume54
Issue number1
StatePublished - 1992

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Eicosanoids
Endothelins
Liver Transplantation
Hemodynamics
Kidney
Thromboxanes
Epoprostenol
Immunosuppression
Transplants
Renal Circulation
Vasoconstriction
Aldosterone
Renin
Liver Cirrhosis
Cyclosporine
Liver Diseases
Arterial Pressure
Theoretical Models
Transplantation
Hormones

ASJC Scopus subject areas

  • Immunology
  • Transplantation

Cite this

Renal hemodynamics, urinary eicosanoids, and endothelin after liver transplantation. / Textor, Stephen C; Wilson, D. J.; Lerman, Amir; Romero, J. C.; Burnett, John C Jr.; Wiesner, R.; Dickson, E. R.; Krom, R. A F.

In: Transplantation, Vol. 54, No. 1, 1992, p. 74-80.

Research output: Contribution to journalArticle

Textor, SC, Wilson, DJ, Lerman, A, Romero, JC, Burnett, JCJ, Wiesner, R, Dickson, ER & Krom, RAF 1992, 'Renal hemodynamics, urinary eicosanoids, and endothelin after liver transplantation', Transplantation, vol. 54, no. 1, pp. 74-80.
Textor, Stephen C ; Wilson, D. J. ; Lerman, Amir ; Romero, J. C. ; Burnett, John C Jr. ; Wiesner, R. ; Dickson, E. R. ; Krom, R. A F. / Renal hemodynamics, urinary eicosanoids, and endothelin after liver transplantation. In: Transplantation. 1992 ; Vol. 54, No. 1. pp. 74-80.
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