Efficacy of L-Ornithine-L-Aspartate in Cirrhotics With Hepatic Encephalopathy

Launched by AGA KHAN UNIVERSITY · Feb 8, 2007

Keywords

ClinConnect Summary

There is no effective treatment available for hepatic encephalopathy at the moment; therefore we aimed to check the efficacy and safety of L-ornithine L-aspartate(LOLA). It provides critical substrates for ureagenesis and glutamine synthesis, the two primary mechanisms by which the body rids itself of excess ammonia. Ornithine is a specific activator of ornithine carbamyl transferase and carbamylphosphate synthetase, and, in addition, is a substrate for ureagenesis. These reactions are carried out mainly in the periportal portion of the hepatic lobules. Aspartate and ornithine, after conver...

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Eligibility criteria

• Inclusion Criteria:
• • Cirrhosis, diagnosed on the basis of clinical findings, sonographic, and/or histologic basis,
• • Patients \>14 years, with HE grades 1 to 4 according to West Haven Criteria,
• • Hyperammonemia (fasting venous blood ammonia level \>60 µmol/l), and
• • Patients with a single reversible precipitating factor of HE such as constipation, hypokalemia, urinary tract infection, respiratory tract infection, spontaneous bacterial peritonitis (SBP), dehydration, or none.
• Exclusion Criteria:
• • hepatocellular carcinoma,
• • severe septicemia,
• • active gastrointestinal bleeding,
• • hepatorenal syndrome,
• • acute superimposed liver injury,
• • advanced cardiac or pulmonary disease and end stage renal failure,
• • patients with minimal HE
• • patients taking sedatives, antidepressants, or benzodiazepines and
• • patients with chronic HE on metronidazole or lactulose prior to admission.