Reduction of primary nonfunction with prostaglandin E1 after clinical liver transplantation.

~E use ofUW solution l has resulted in improved graft ~ . function after transplantationz.J even with long average preservation times.4 However. although the incidence of primary nonfunction (PNF) has decreased, it remains a significant clinical problem. in part because the demand for livers has caused an increased use of previously discarded organs.' Greig et al6 have reported that prostaglandin E1 (PGE I ) can ameliorate. or reverse. severe ischemic injury after liver transplantation. consistent with reports of several prostaglandin agents in experimental hepatic71l and nonhepatic l2•13 test models of ischemic injury. In addition, we have reported that the combination of PGE I plus high-dose steroids favorably influences the course of human liver allografts transplanted despite a positive Iymphocytotoxic cross match14 and that PGE, in cross-match negative cases reduces FK 506 nephrotoxicity. IS Consequently. we began in October 1991 to give PGE , perioperatively to all liver recipients with a subsequent very low (1.1 %) incidence of PNF in 174 consecutive negative cross-match cases.