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: 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
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 March 1, 2021.« Back to 2018 American Transplant Congress