Effect of ursodeoxycholic acid on liver regeneration capacity after living donor hepatectomy: a prospective, randomized, double-blind clinical trial

- OBJECTIVE: Ursodeoxycholic acid (UDCA) has multiple hepatoprotective ac-tivities: it modifies the bile acid pool, decreas-es levels of endogenous, hydrophobic bile ac-ids while increasing the proportion of nontoxic hydrophilic bile acids. It also has cytoprotective, antiapoptotic, and immunomodulatory proper-ties. The aim of this study was to analyze the ef-fect of postoperative administration of UDCA on liver regeneration capacity.PATIENTS AND METHODS: This is a sin-gle-center, prospective, randomized, dou-ble-blind study that was carried out in our Liv-er transplant Institute. Sixty living liver donors (LLDs) who underwent right lobe living donor hepatectomy were divided into two groups us-ing computer-generated random numbers: one group received oral UDCA 500 mg 12 hourly for 7 days (UDCA group; n=30) from the first postop-erative day (POD) and the other did not receive UDCA (non-UDCA group; n=30). Both groups were compared in terms of the following param-eters: clinical and demographic parameters, liv-er enzymes (ALT, AST, ALP, GGT, total bilirubin, direct Bilirubin), and INR. RESULTS: The median ages in the UDCA and non-UDCA were 31 years (95% CI for median: 26-38) and 24 years (95% CI for median: 23-29), respectively. Liver function tests showed signif-icant differences at various times within the first seven PODs. The INR was lower in UDCA group patients on POD3 and POD4. However, GGT was significantly lower on POD6 and POD7 for the UDCA group. Total bilirubin was also significant-ly lower on POD3 for the UDCA group patients, but ALP was lower all from POD1 to POD7. A sig-nificant difference was also observed in AST on POD3, POD5 and POD6. CONCLUSIONS: Postoperative administra-tion of oral UDCA significantly improves liver function tests and INR among LLDs.