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28 Multiple RCTs have studied the efficacy of intravenous and oral LOLA compared to placebo for treatment of HE (such as lactulose)

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4.4 Integrated clinical insights and cross-organ implications To consolidate the clinical evidence: across heart, brain, liver, and kidney domains, there is a unifying theme that mitochondrial dysfunction in immune and parenchymal cells contributes to perioperative organ injury, and conversely, that interventions targeting mitochondrial preservation or immune modulation correlate with improved outcomes (even if modestly in some cases) (28, 64)