Ursodiol Prophylaxis in Recipients of Liver Transplant From Donors After Cardiac Death

Objectives: This study aimed to assess the efficacy of ursodiol in preventing biliary complications after transplant of livers from donors after cardiac death. Materials and Methods: This was a single-center, nonrandomized, retrospective study that evaluated biliary complication rates in patients who received ursodiol (13-15 mg/kg/day) for 30 days (n = 32; postursodiol group) compared with patients who did not receive ursodiol after liver transplant from a cardiac death donor (n = 36; pre-ursodiol group [before introduction of ursodiol in the prophylaxis regimen]). Data were collected from September 2012 to September 2021. Patients were included if they were at least 19 years old and received a liver transplant from a donor after cardiac death. The primary endpoint of this study was to determine whether ursodiol decreased biliary complications within 30 days posttransplant. Secondary endpoints included change in biochemical serum liver tests (aspartate aminotransferase, alanine amino-transferase, total bilirubin, and alkaline phosphatase) and time to identification of hepatobiliary complications at posttransplant days 7, 14, and 28, acute graft loss, biopsy-proven acute rejection, and patient survival at 1 and 6 months. Results: Biliary complications were similar between groups. Four patients (12.5%) experienced biliary complications in the post-ursodiol group versus 1 patient (2.9%) in the pre-ursodiol group (not significant, P = .19). Biochemical liver enzymes at days 7, 14, and 28 were also not significant different between groups. Acute graft loss, biopsy-proven acute rejection, and patient survival at 1 and 6 months were similar between the 2 groups. Conclusions: Ursodiol prophylaxis did not show a diff-rence in preventing biliary complications for recipients of liver transplant from donors after cardiac death.