1.Application of tranexamic acid on effects of intraoperative hemorrhage in liver transplantation
Zhenglei QIAO ; Boting WU ; Mi JIANG ; Ruiming RONG
Chinese Journal of Blood Transfusion 2017;30(7):737-739
Objective To evaluate the efficacy and safety of tranexamic acid in blood protection in liver transplantation.Methods We searched the Cochrane library,MEDLINE,CNKI,VIP,CBM (from inception to May 2017),to collect all the randomized controlled trials of tranexamic acid for liver transplantation.the quality of the included studies was evaluated,and meta-analyses were performed with Cochrane Collaboration's RevMan 5.3 software.Results 1) A total of 8 studies involving 1107 patients were included.the results of meta-analyses showed:Compared with placebo,tranexamic acid was effective in reducing postoperative blood loss [SMD =-1.95,95% CI (-3.21,-0.69)],P<0.05],there were statistical heterogeneity between the studies (I2=94%,P<0.05),2)Tranexamic acid was effective in reducing postoperative transfusion rates of RBC during the operation [SMD=-0.43,95% CI (-0.74,-0.11)],P<0.05];however,less effective than the placebo in terms of reducing postoperative FFP and PLT transfusion.Compared with placebo and other antifibrinolitic drugs the bleeding,renal insufficiency,thrombosis,infection,death and the incidence of other adverse events were not increased in tranexamic acid group after surgery.Conclusion Tranexamic acid was a safe and effective antifibrinolitic drug in liver transplantation,for it can reduce the amount of bleeding and red blood cell transfusion,However,due to the limited quality of the included studies,further verification with more high quality trials was needed.
2.Effect of UGT2B7 genetic variants on serum valproic acid concentration
Hongying MA ; Ting ZHANG ; Zhicheng GONG ; Boting ZHOU ; Ming ZOU ; Shan XIAO ; Wu ZHU
Journal of Central South University(Medical Sciences) 2013;38(8):766-772
Objective: To investigate the effect of UGT2B7 A268G and UGT2B7 G211T genetic polymorphism on serum drug concentration of valproic acid (VPA).
Methods:Genetic polymorphisms of UGT2B7 A268G and UGT2B7 G211T were tested in 248 epileptic patients by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). Data including basic information, epilepsy type, times and doses of drug, treatment response and liver and kidney functions were collected. Statistical analysis was performed by SPSS 13.0 through multivariate linear regression, one-way ANOVA,χ2 test, and paired T-test.
Results:Based on multivariate linear regression, there was no significant difference between gender, age, or body mass index and VPA, but concentration-to-dose ratios (CDRs) were positively correlated with VPA. hTe genetic polymorphisms of UGT2B7 A268G and UGT2B7 G211T were consistent with Hardy-Weinberg equilibrium. UGT2B7-268A>G allele frequency distribution A was 30.05%, and G was 69.95%. Variance analysis showed that serum drug concentration was significantly different in the genotype of AA, AG, or GG (F=5.477, P=0.005). Further analysis of paired T test showed that AA type was significantly different from GG type (P=0.048), and that serum concentration of AA type was much higher than that of GG type, while no signiifcant difference between AA type and AG type, GG type and AG type. UGT2B7 G211T allele frequency distribution G was 77.24%, and T was 22.58%. hTere was no signiifcant difference in standardized serum concentration among genotypes of GG, GT, and TT.
Conclusion:hTis study reveals UGT2B7 A268G genetic polymorphism distribution in Chinese epilepsy population. UGT2B7 A268G plays an important role in VPA’s metabolism, and has certain effect on VPA’s serum concentration. Epilepsy patient with this genotype should be adjusted the dose of VPA to make a therapeutic effect.