1.1. Background 1.1.1. Perioperative ischaemia/reperfusion (I/R) injury during liver
transplantation is strongly associated with early allograft dysfunction, graft loss, and
mortality.
1.1.2. Hepatic I/R injury also causes remote damage to other organs including the renal and
pulmonary systems.
1.1.3. Dexmedetomidine, a selective α2-adrenoceptor agonist which is widely used as an
adjuvant to general anaesthesia, has been widely shown in preclinical studies to provide
organoprotection by ameliorating the effects of I/R injury in a range of tissues (including
the liver). However, prospective clinical evidence of any potential benefits in improving
outcomes in liver transplantation is lacking.
1.2. Objectives 1.2.1. To investigate the hypothesis that perioperative treatment with
dexmedetomidine reduces the incidence of early allograft dysfunction and primary graft
non-function in deceased donor liver transplantation.
1.2.2. The impact of dexmedetomidine on postoperative renal and pulmonary function will also
be examined.
1.3. Study Design This is a prospective, single-centre, randomised, parallel-group study.
1.4. Setting Departments of Anesthesiology, Renji Hosptial, Shanghai Jiao Tong University
School of Medicine, Shanghai, 200127, China.
1.5. Patients 200 patients (18-65 years) scheduled to undergo liver transplantation under
general anaesthesia.
1.6 Intervention 1.6.1. For the patients in the treatment group, a loading dose of
dexmedetomidine will be given after induction of anaesthesia (1μg/kg over 10 min) followed by
a continuous infusion (0.5μg/kg /h) until the end of surgery.
1.6.2. For patients in the placebo group, an equal volume loading dose of 0.9% saline will be
given after the induction of anaesthesia followed by an equal volume continuous infusion
until the end of surgery.
1.6.3. All other supplements, e.g. opioids, sedatives and muscle relaxant, will be identical
in the both arms and administered according to routine clinical practice.