Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 26 May 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Bile acids not beneficial in liver transplant patients

Bile acids are well tolerated by liver transplant patients, but do not reduce all-cause mortality, retransplantation, or cellular rejection, however, do reduce chronic rejection in a fixed-effect model, reports the latest issue of the Cochrane Database of Systematic Reviews.

News image

fiogf49gjkf04

Liver transplantation has become a widely accepted form of treatment for numerous end-stage liver diseases.

Bile acids may decrease the degree of allograft rejection after liver transplantation.

This may occur by changing the expression of major histocompatibility complex class molecules in bile duct epithelium and central vein endothelium.

Dr Chen Gluud and colleagues assessed the beneficial and harmful effects of bile acids for liver-transplanted patients.

The research team performed searches of the Cochrane Hepato-Biliary Group Trials Register, CENTRAL, MEDLINE, and EMBASE to 2003.

The team also searched The Chinese Biomedical Database to 2002.

The researchers included all randomized clinical trials comparing any dose of bile acids or duration of treatment in liver-transplanted patients versus placebo.

Randomized clinical trials that compared bile treatment but had no intervention, or another intervention were also included.

The team included randomized clinical trials irrespective of blinding, language, and publication status.

6 out of 7 randomized trials identified evaluated ursodeoxycholic acid vs placebo
The Cochrane Database of Systematic Reviews

The researchers independently extracted and validated the data.

The methodological quality of the trials was evaluated from the method for generation of the allocation sequence, and allocation concealment.

The team also considered double blinding, and follow-up as part of the methodological quality assessment.

The team used intention-to-treat principle to perform meta-analyses.

The outcomes were presented as relative risk or weighted mean difference, both with 95% confidence intervals.

The research team identified 7 randomised trials, of which 6 evaluated ursodeoxycholic acid versus placebo or no intervention.

A further 1 of these trials evaluated tauro-ursodeoxycholic acid versus no intervention with a total of 335 liver-transplanted patients.

The team noted that the administration of bile acids began 1 day or more after liver transplantation.

All patients received the standard triple-drug immunosuppressive regimen of steroids, azathioprine, and cyclosporine or tacrolimus.

The triple-drug regimen was used to suppress the allograft rejection response after liver transplantation.

The team found that bile acids did not significantly reduce all-cause mortality, or mortality related to allograft rejection.

In addition, the team found that bile acids did not reduce retransplantation, acute cellular rejection, or number of patients with steroid-resistant rejection.

Bile acids significantly reduced the number of patients who had chronic rejection in a fixed-effect model but not in a random-effects model.

The researchers noted that bile acids were safe and well tolerated by liver-transplanted patients.

Dr Gluud's team concludes, “Bile acids do not seem to have significant beneficial effects in liver-transplanted patients.”

Cochrane 2005:3: Art. No.: CD005442. DOI: 10.1002/14651858.CD005442
05 August 2005

Go to top of page Email this page Email this page to a colleague

 25 May 2018 
Colorectal cancer–specific mortality
 25 May 2018 
Technology to increase colorectal cancer screening
 25 May 2018 
Post‐operative complications in elderly IBD
 24 May 2018 
Patient-reported outcome measures in IBD trials
 24 May 2018 
Alcohol consumption and outcomes in drug-induced liver injury
 24 May 2018 
Precision medicine for tumors
 23 May 2018 
Management of perianal fistulas in Crohn’s disease
 23 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 23 May 2018 
High body mass index is and ulcerative colitis
 22 May 2018 
Worldwide H.pylori prevalence
 22 May 2018 
PPI and risk of stroke
 22 May 2018 
Online tool predicts bowel dysfunction severity prior to anterior resection
 21 May 2018 
Depressive symptoms in IBD youth
 21 May 2018 
PPI use and cognitive decline
 21 May 2018 
Fecal incontinence and quality of life in IBD
 18 May 2018 
Esophageal dilatation in clinical practice 
 17 May 2018 
IBD and later extraintestinal manifestations
 17 May 2018 
Repeat stool DNA testing
 17 May 2018 
IBS and chronic fatigue following GI infection
 16 May 2018 
Factors associated with fecal incontinence
 16 May 2018 
Diagnostic delay in Crohn's disease
 16 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 15 May 2018 
Guidelines for management of Crohn's
 15 May 2018 
Hep B in the Grey Zone
 15 May 2018 
New therapies for CDI
 14 May 2018 
Blood test for the diagnosis of fibrotic NASH
 14 May 2018 
Outcomes at bariatric centers of excellence
 14 May 2018 
Management of perianal fistulas in Crohn’s
 11 May 2018 
Detection of undiagnosed celiac disease
 11 May 2018 
Alcohol consumption and drug-induced liver injury
 10 May 2018 
Colorectal cancer screening
 10 May 2018 
Fibrosis in patients with chronic hepatitis B
 09 May 2018 
Fecal incontinence
 09 May 2018 
Health problems and IBS
 09 May 2018 
Esophageal dilatation in clinical practice 
 07 May 2018 
Omitting antibiotics in uncomplicated acute diverticulitis
 07 May 2018 
Health problems and IBS
 07 May 2018 
Assessment of diminutive colorectal polyps
 04 May 2018 
National Institutes of Health workshop and obesity
 04 May 2018 
Factors associated with fecal incontinence
 04 May 2018 
Colorectal cancer screening and ethnic inequities
 03 May 2018 
Gastrointestinal ultrasound in IBD
 03 May 2018 
Ultransonography in postsurgical recurrence in Crohn's
 02 May 2018 
Symptom assessment in cirrhotic ascites
 02 May 2018 
Hep C antiviral treatment and liver cancer risk
 02 May 2018 
Chronic Hep B
 01 May 2018 
European guidelines on pancreatic cystic neoplasms
 01 May 2018 
Interferon‐free regimens in Hep C
 01 May 2018 
Age at IBD onset and extraintestinal complications
 30 April 2018 
Formula for preterm infants
 30 April 2018 
Primary antibiotic resistance and sequential therapy for H. pylori
 27 April 2018 
Eastern and western practices for endoscopic resection of colorectal lesions
 27 April 2018 
Anxiety scale for chronic esophageal disease
 27 April 2018 
Disease activity in eosinophilic esophagitis
 26 April 2018 
Obesity and physical activity in diverticulosis
 26 April 2018 
Primary sclerosing cholangitis in the USA
 25 April 2018 
Aspirin and pancreatic cancer
 25 April 2018 
Central mediators of irinotecan-induced steatohepatitis
 25 April 2018 
Neuroimaging in Hep C
 24 April 2018 
Scoring system identifies cancer risk in Barrett's

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us