The protective role of dexmedetomidine on hepatic injury of the donor of liver transplant: a randomized controlled trial
Abstract
Background & objective: Living donor liver transplantation is one of the definite solutions for patients with end-stage liver disease. Donor safety is of utmost importance during this procedure. Hepatic Injury may be prevented by dexmedetomidine (DEX) and its organ-protective potentials. Our goal was to investigate the protective effects of DEX on the donor liver during transplantation.
Methods: This trial included 50 living liver donors, who were randomly assigned as 25 donors in the DEX group receiving an infusion of DEX 0.5 µg/kg/h and 25 donors in the control group receiving a comparable placebo saline infusion. The primary outcome was the measurement of tumor necrosis factor (TNF-α) levels using enzyme-linked immunosorbent assay (ELISA) test. Other outcomes included intraoperative hemodynamics, intraoperative opioid requirements, postoperative liver profile, postoperative complications, and intensive care unit (ICU) stay.
Results: TNF-α levels were significantly lower in the DEX group than those of the control group on postoperative day 1 (POD1). Additionally, the DEX group had significantly lower levels of alanine aminotransferase, aspartate aminotransferase at POD0 and POD1 and lower levels of lactic dehydrogenase at POD0. There was no statistically significant difference between both groups regarding postoperative complications and ICU length of stay.
Conclusion: Dexmedetomidine demonstrated protective potentials against liver damage following hepatectomy in donors for liver transplant.
Keywords: Dexmedetomidine; Donor of Liver transplant; Hepatic injury; Donor safety; Tumor necrosis factor-α; Liver transplantaion.
Trial registration: Pan African Clinical Trial Registry number: (PACTR202404838380059) on April 25, 2024.
Citation: ElShafie MA, Hassan GA, Eskandr AM, Ali MT, Sultan AA. The Protective Role of Dexmedetomidine on Hepatic Injury of the Donor of Liver Transplant: A Randomized Controlled Trial. Anaesth. pain intensive care. 2026;30(5):581-590. DOI: 10.35975/apic.v30i5.3256
Received: February 13, 2016; Revised: February 28, 2016; Accepted: March 31, 2026
