Correlations of Postreperfusion Syndrome in Liver Transplant Recipients
Anesthesia and Intensive Care, Fundeni Clinical Institute, Bucharest, Romania
Digestive Surgery and Liver Transplantantion, Fundeni Clinical Institute, Bucharest, Romania
Meeting: 2013 American Transplant Congress
Abstract number: A622
Background and goal of study: A period of hemodynamic instability following unclamping of the portal vein and liver reperfusion during liver transplantation is frequently observed and is termed postreperfusion syndrome (PRS). The aim of this study was to identify the incidence of the PRS in a group of liver transplant recipients and the predictors associated with this syndrome.
Materials and Methods: After approval of local ethical committee, 35 consecutive liver transplant patients were included in a retrospective observational study. All patients underwent liver transplant under general anesthesia with invasive hemodynamic monitoring (Swan-Ganz catheter). The variables recorded were: age, etiology of the liver disease, MELD score for the cirrhotic recipients, the associated pathologies, Β-blocker therapy, and duration of the surgical procedure and of the anhepatic phase, volume of bleeding, intraoperative vasoconstrictor and/or inotrope requirements and the length of postoperative intensive care unit stay. Statistical analysis was performed using SPSS Statistics v.19.1.
Results and Discussion: PRS was considered when the mean arterial pressure was 30% lower than the value at the end of the anhepatic stage and lasted for at least 1 minute within the first 5 minutes after unclamping. PRS occurred in 57.1% of the patients undergoing liver transplantation. Statistically significant correlations were found between the occurrence of PRS, the age of the recipients and the duration of the anhepatic phase. The patients with PRS had a significantly longer duration of ICU stay. We couldn’t find a correlation between PRS and the etiology of the liver disease, MELD score, the duration of the surgery or the volume of intraoperative bleeding.
Conclusions: Reperfusion is a critical period during liver transplantation, as it is frequently associated with serious hemodynamic instability. The knowledge of predictive factors for PRS would be very useful as it could help the anesthesiologist to identify patients at risk and perhaps to elaborate new strategies to prevent PRS. Our study showed that the duration of the anhepatic stage and the age of the recipients have a potential role in the appearance of PRS during liver transplantation and also that PRS has negative impact on the short-term postoperative outcome.
To cite this abstract in AMA style:
Droc G, Scarlatescu E, Tomescu D, Ungureanu D, Fota R, Cristea A, Popescu M, Popescu I. Correlations of Postreperfusion Syndrome in Liver Transplant Recipients [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/correlations-of-postreperfusion-syndrome-in-liver-transplant-recipients/. Accessed November 22, 2024.« Back to 2013 American Transplant Congress