17 research outputs found
Postreperfusion Cardiac Arrest and Resuscitation During Orthotopic Liver Transplantation
Postreperfusion hyperkalemia in liver transplantation using donation after cardiac death grafts with pathological changes
Compared efficacy of University of Wisconsin and histidine-tryptophan-ketoglutarate solutions in ex-situ liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis patients
Graft rinse prior to reperfusion in liver transplantation: literature review and online survey within the Eurotransplant community
Inhibitory effect of a reproductive-related serpin on sperm trypsin-like activity implicates its role in sperm maturation of Penaeus monodon
Crystalloid flush with backward unclamping may decrease post-reperfusion cardiac arrest and improve short-term graft function when compared to portal blood flush with forward unclamping during liver transplantation
During liver transplant (LT), the release of vasoactive substances into the systemic circulation is associated with severe hemodynamic instability that is injurious to the recipient and/or the postâischemic graft. Crystalloid flush with backward unclamping (CB) and portal blood flush with forward unclamping (PF) are two reperfusion methods to reduce reperfusionârelated cardiovascular perturbations in our center. The primary aim of this study was to compare these two methods. After institutional review board (IRB) approval, cadaveric whole LT cases performed between 2003 and 2008 were reviewed. Patients were divided into two groups based on reperfusion methods: CB or PF. After background matching with propensity score, the effect of each method on postâoperative graft function was assessed in detail. In our cohort of 478 patients, CB was used in 313 grafts and PF in 165. Thirtyâday graft survival was lower, and risk of retransplantation was higher in PF. Multivariable model showed that CB is an independent factor to reduce primary nonâfunction, cardiac arrest and improve 30âd graft survival. Also, the incidence of ischemicâtype biliary lesions was significantly higher in the PF group. Reperfusion methods affect intraoperative hemodynamics and postâtransplant outcome. CB allows for control over temperature and composition of the perfusate, perfusion pressure, and the rate of infusion