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.
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.
Participants were randomized to receive either intravenous ω-3 PUFA– enriched lipid emulsion 20% infusion, or glucose 5%.
40 adult living donors aged 18-45 years scheduled for elective hepatic resections for living donor liver transplantaton (LDLT).
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.
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.
Cochrane Research Database of South Africa - PACTR 201501000982252