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

A. Hassan, J. Cywinski, Q. Liu, D. Pezzati, D. Yang, L. Liu, G. Iuppa, K. Hashimoto, F. Aucejo, M. Fujiki, B. Eghtesad, S. Irefin, J. Fung, K. Abu-Elmagd, C. Miller, C. Quintini.

Transplant Surgery, Cleveland Clinic, Cleveland.

Meeting: 2018 American Transplant Congress

Abstract number: D46

Keywords: Ischemia, Liver preservation, Liver transplantation, Preservation

Session Information

Date: Tuesday, June 5, 2018

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

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

 Presentation Time: 6:00pm-7:00pm

Location: Hall 4EF

Related Abstracts
  • Correlations of Postreperfusion Syndrome in Liver Transplant Recipients
  • Normothermic Ex Vivo Liver Perfusion (NEVLP) Using Steen Solution as Preservation Technique for Liver Transplantation-First Clinical Results.

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).

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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 March 1, 2021.

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