ATC Abstracts

American Transplant Congress abstracts

The Role of Ex Vivo Normothermic Preservation in Minimizing Postreperfusion Syndrome in Liver Transplantation

Transplant Surgery, Cleveland Clinic, Cleveland.

Meeting: 2018 American Transplant Congress

Abstract number: D46

Keywords: , , ,

Session Information

Session Name: Poster Session D: Ischemia Reperfusion Injury: Time to Change the Fate?

Session Type: Poster Session

Date: Tuesday, June 5, 2018

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall 4EF

Background:Graft reperfusion holds a major challenge during liver transplantation. NMP may improve post-reperfusion hemodynamics, reduce vasopressor and blood product transfusion.

Methods:15 patients with liver transplantation after NMP were matched with Cold storage (CS) group.Intraoperative records of vasopressors, arterial blood gas, TEG parameters, and blood products during post-reperfusion phase were collected. Post-reperfusion syndrome was defined as severe hemodynamic instability (mean arterial pressure dropped >30% of the anhepatic level),asystole, arrhythmias or fibrinolysis.

Results: NMP group had lower post-reperfusion syndrome rate (13 % (2) vs. 46 % (28), p=0.01), and received less amount of PRBC, FFP, cryoprecipitate and crystalloids compared to CS group.TEG coagulation index was higher in NMP than CS.

NMP N=15 CS N=60 p
Asystole/arrhythmia 0 2 0.4
MAP drop>30% 0 5% (3) 0.3
anti-fibrinolytic 13%(2) 41%(25) 0.04
Vasopressors
Norepinephrine 1663±2059 2476±2235 0.2
Epinephrine 341±1297 170±663 0.4
Vasopressin 2±4 13±65 0.5
Fluids,cc
Colloids 1183±903 887±975 0.2
Crystalloids 646±796 1908±1625 <0.001
Blood products,cc
PRBC 257±311 1150±1059 <0.001
FFP 146±263 957±993 <0.001
Platelets 266±290 488±475 0.09
Cryo 51±108 156±235 0.01
Cell saver 888±979 1535±1482 0.1
Blood loss 5056±5552 6621±7866 0.4
TEG
R value 9±6 8±2 0.4
K value 6±3 7±4 0.3
Lysis time 2±7 2±5 0.9
MA 37±11 35±9 0.4
Coagulation index 3±2 7±4 0.001
Degree Angle 42 ±14 42±12 0.9

Conclusion:NMP is associated with more stable hemodynamic, reduced post-reperfusion syndrome rate, better metabolic and coagulation profile after reperfusion compared to CS group, which needs to be investigated in larger study.

CITATION INFORMATION: Hassan A., Cywinski J., Liu Q., Pezzati D., Yang D., Liu L., Iuppa G., Hashimoto K., Aucejo F., Fujiki M., Eghtesad B., Irefin S., Fung J., Abu-Elmagd K., Miller C., Quintini C. The Role of Ex Vivo Normothermic Preservation in Minimizing Postreperfusion Syndrome in Liver Transplantation Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Hassan A, Cywinski J, Liu Q, Pezzati D, Yang D, Liu L, Iuppa G, Hashimoto K, Aucejo F, Fujiki M, Eghtesad B, Irefin S, Fung J, Abu-Elmagd K, Miller C, Quintini C. The Role of Ex Vivo Normothermic Preservation in Minimizing Postreperfusion Syndrome in Liver Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/the-role-of-ex-vivo-normothermic-preservation-in-minimizing-postreperfusion-syndrome-in-liver-transplantation/. Accessed November 21, 2024.

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