Orthotopic Liver Transplantation Without Venovenous Bypass: 125 Cases From a Single Center

AbstractAimThis study analyzed a 10-year single-center experience in orthotopic liver transplantation (OLT) without venovenous bypass (VVB).MethodsWe retrospectively analysed a nonrandomized series (1999-2008) of 125 adult OLT patients without VVB.ResultsThe main causes of liver failure were viral hepatitis (n = 39), alcoholic liver disease (n = 22), and liver cancer (n = 17). One-year survival was 76.4%. The most common postoperative complications were bile duct stenosis (n = 12), postoperative bleeding (n = 8), hepatic artery thrombosis (n = 7), and primary liver failure (n = 6). Twelve patients required hemodialysis and four underwent retransplantations of the liver. Fourteen patients died before postoperative day 30th. Univariate analysis showed significant differences between patients who did and did not survive 30 days among donor death diagnoses (P = .05), red blood cell units transfused (P = .03), aspartate aminotranferase on the first postoperative day (P = .002), ABO type (P = .04), time of orotracheal intubation (P = .001), hemodialysis (P = .001), and period of postoperative vasoactive drug use (P = .006). The total length of orotracheal tube intubation showed a significant independent association with mortality before 30 days (P < .001).ConclusionOLT without VVB can be safely performed even in severe cases of chronic liver failure