Effect of omega-3 on hepatic regeneration in adult living donors undergoing hepatic resections for liver transplantation: A randomized controlled trial.
Ibrahim ES, Saleh SM, et al.Journal of Critical Care 2016; 31(1): 157-162.
Aims
To investigate the effect of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) on hepatic regeneration in adult living donors undergoing partial hepatectomy for liver transplantation.
Interventions
Participants were randomized to receive either intravenous ω-3 PUFA– enriched lipid emulsion 20% infusion, or glucose 5%.
Participants
40 adult living donors aged 18-45 years scheduled for elective hepatic resections for living donor liver transplantaton (LDLT).
Outcomes
The primary outcome measured was the volume of the liver after 1 month. Secondary outcomes measured were serial changes of serum levels of hepatocyte growth factor (HGF) and conventional liver function test results.
Follow-up
1 month
CET Conclusions
This interesting, well designed study from Egypt investigates the role of omega-3 supplementation on liver regeneration following living donor partial hepatectomy. Donors were randomised to receive omega-3 infections two days prior to donation, or a control group of 5% glucose. Randomisation was performed in the pharmacy department, and the anaesthetic team and surgeons were blinded to the infusion given. The manuscript reports a significantly larger liver volume (assessed on CT) at day 30 after surgery in the treatment arm, with reduced ALT/AST and increased serum levels of hepatocyte growth factor. Whilst these findings are very interesting, there are some caveats. The functional benefit of the small volume difference (around 120cm^3) observed is uncertain, and it is unclear whether omega-3 simply accelerates regeneration, or improves eventual liver volume due to the relatively short follow-up. No biopsies were performed as they were not permitted by the local ethical committee. A larger study with longer follow-up would certainly be of interest.
Data analysis
Per protocol analysis
Trial registration
Cochrane Research Database of South Africa - PACTR 201501000982252