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Browsing by Author "Barbara, Marco"
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Item Donor Simvastatin Treatment Is Safe and Might Improve Outcomes After Liver Transplantation: A Randomized Clinical Trial(Wolters Kluwer, 2022) Pagano, Duilio; Bosch, Jaime; Tuzzolino, Fabio; Oliva, Elisabetta; Ekser, Burcin; Zito, Giovanni; Cintorino, Davide; di Francesco, Fabrizio; Petri, Sergio Li; Ricotta, Calogero; Bonsignore, Pasquale; Calamia, Sergio; Magro, Bianca; Trifirò, Gianluca; Alduino, Rossella; Barbara, Marco; Conaldi, Pier Giulio; Gallo, Alessia; Venuti, Francesca; Luca, Angelo; Gruttadauria, Salvatore; Surgery, School of MedicineBackground: The current curative approaches for ischemia/reperfusion injury on liver transplantation are still under debate for their safety and efficacy in patients with end-stage liver disease. We present the SIMVA statin donor treatment before Liver Transplants study. Methods: SIMVA statin donor treatment before Liver Transplants is a monocentric, double-blind, randomized, prospective trial aiming to compare the safety and efficacy of preoperative brain-dead donors' treatment with the intragastric administration of 80 mg of simvastatin on liver transplant recipient outcomes in a real-life setting. Primary aim was incidence of patient and graft survival at 90 and 180 d posttransplant; secondary end-points were severe complications. Results: The trial enrolled 58 adult patients (18-65 y old). The minimum follow-up was 6 mo. No patient or graft was lost at 90 or 180 d in the experimental group (n = 28), whereas patient/graft survival were 93.1% ( P = 0.016) and 89.66% ( P = 0.080) at 90 d and 86.21% ( P = 0.041) and 86.2% ( P = 0.041) at 180 d in the control group (n = 29). The percentage of patients with severe complications (Clavien-Dindo ≥IIIb) was higher in the control group, 55.2% versus 25.0% in the experimental group ( P = 0.0307). The only significant difference in liver tests was a significantly higher gamma-glutamyl transferase and alkaline phosphatase at 15 d ( P = 0.017), ( P = 0.015) in the simvastatin group. Conclusions: Donor simvastatin treatment is safe, and may significantly improve early graft and patient survival after liver transplantation, although further research is mandatory.