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Cherchi V, Vetrugno L, Zanini V, Pravisani R, Ventin M, Lorenzin D, Adani GL, Clocchiatti L, Boscolo E, Vit A, Sponza M, D'Alì L, Di Loreto C, Bove T, Terrosu G, Risaliti A, Baccarani U. Association between indocyanine green clearance test and ischemic type biliary lesions within one year after orthotopic liver transplantation. GASTROENTEROLOGIA Y HEPATOLOGIA 2021; 44:687-695. [PMID: 34023468 DOI: 10.1016/j.gastrohep.2021.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/03/2021] [Accepted: 03/29/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Ischemic type biliary lesions (ITBLs), a particular subset of non-anastomotic biliary strictures (NAS), are characterized by intra and extrahepatic strictures that occur in the absence of either hepatic artery thrombosis or stenosis. When they occur within the first year after liver transplantation their development is mostly related to ischemia-reperfusion injury (IRI). The indocyanine green plasma disappearance rate (ICG-PDR) might be able to predict the probability of IRI-induced graft damage after liver transplantation. OBJECTIVE Our aim was to evaluate the association between ICG-PDR and the occurrence of ITBLs. Secondly, we searched for evidence of IRI in patients presenting ITBLs. METHODS This retrospective single-center observational study assessed a cohort of 60 liver transplant patients. Each patient underwent ICG-PDR on the 1st postoperative day. ITBLs were identified by means of either cholangiography or magnetic resonance imaging evidence of a deformity and narrowing of the biliary tree in the absence of hepatic artery thrombosis/stenosis. RESULTS ITBLs were discovered in 10 patients out of 60 liver recipients (16.67%) within one year after transplantation. A low ICG-PDR value was found to be a significant predictive factor for ITBL development, with an OR of 0.87 and a 95% CI of 0.77-0.97. Liver biopsies were performed in 56 patients presenting unexplained abnormal liver function test results. A statistically significant association was found between the development of ITBLs and anatomopathological evidence of IRI. LIMITATIONS Retrospective, single-center study. CONCLUSIONS The findings from this study show a relationship between low ICG-PDR values on first post-operative-day and the occurrence of ITBLs within 1 year after transplantation.
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Affiliation(s)
- Vittorio Cherchi
- General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, P.le S. Maria della Misericordia 15, 33100 Udine, Italy
| | - Luigi Vetrugno
- Department of Medicine, University of Udine, Via Colugna n° 50, 33100 Udine, Italy; Department of Anesthesia and Intensive Care, University-Hospital of Udine, P.le S. Maria della, Misericordia n° 15, 33100 Udine, Italy
| | - Victor Zanini
- Department of Medicine, University of Udine, Via Colugna n° 50, 33100 Udine, Italy; Department of Anesthesia and Intensive Care, University-Hospital of Udine, P.le S. Maria della, Misericordia n° 15, 33100 Udine, Italy
| | - Riccardo Pravisani
- General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, P.le S. Maria della Misericordia 15, 33100 Udine, Italy; Department of Medicine, University of Udine, Via Colugna n° 50, 33100 Udine, Italy
| | - Marco Ventin
- Department of Medicine, University of Udine, Via Colugna n° 50, 33100 Udine, Italy.
| | - Dario Lorenzin
- General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, P.le S. Maria della Misericordia 15, 33100 Udine, Italy
| | - Gian Luigi Adani
- General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, P.le S. Maria della Misericordia 15, 33100 Udine, Italy
| | - Lucrezia Clocchiatti
- General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, P.le S. Maria della Misericordia 15, 33100 Udine, Italy; Department of Medicine, University of Udine, Via Colugna n° 50, 33100 Udine, Italy
| | - Erica Boscolo
- General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, P.le S. Maria della Misericordia 15, 33100 Udine, Italy; Department of Medicine, University of Udine, Via Colugna n° 50, 33100 Udine, Italy
| | - Alessandro Vit
- Division of Vascular and Interventional Radiology, University-Hospital of Udine, P.le S. Maria della, Misericordia n° 15, 33100 Udine, Italy
| | - Massimo Sponza
- Division of Vascular and Interventional Radiology, University-Hospital of Udine, P.le S. Maria della, Misericordia n° 15, 33100 Udine, Italy
| | - Lorenzo D'Alì
- Anatomic Pathology Institute, ASUFC University Hospital, University-Hospital of Udine, P.le S. Maria della, Misericordia n° 15, 33100 Udine, Italy
| | - Carla Di Loreto
- Department of Medicine, University of Udine, Via Colugna n° 50, 33100 Udine, Italy; Anatomic Pathology Institute, ASUFC University Hospital, University-Hospital of Udine, P.le S. Maria della, Misericordia n° 15, 33100 Udine, Italy
| | - Tiziana Bove
- Department of Medicine, University of Udine, Via Colugna n° 50, 33100 Udine, Italy; Department of Anesthesia and Intensive Care, University-Hospital of Udine, P.le S. Maria della, Misericordia n° 15, 33100 Udine, Italy
| | - Giovanni Terrosu
- General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, P.le S. Maria della Misericordia 15, 33100 Udine, Italy; Department of Medicine, University of Udine, Via Colugna n° 50, 33100 Udine, Italy
| | - Andrea Risaliti
- Department of Medicine, University of Udine, Via Colugna n° 50, 33100 Udine, Italy
| | - Umberto Baccarani
- General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, P.le S. Maria della Misericordia 15, 33100 Udine, Italy; Department of Medicine, University of Udine, Via Colugna n° 50, 33100 Udine, Italy
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Barrientos-Bonilla AA, Nadella R, Pensado-Guevara PB, Sánchez-García ADC, Zavala-Flores LM, Puga-Olguín A, Villanueva-Olivo A, Hernandez-Baltazar D. Caspase-3-related apoptosis prevents pathological regeneration in a living liver donor rat model. Adv Med Sci 2021; 66:176-184. [PMID: 33676076 DOI: 10.1016/j.advms.2021.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/01/2020] [Accepted: 02/18/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE The main goal of this study was to determine the relationship of cleaved-caspase-3 (C3)-related apoptosis and hepatic proliferation, during the liver repopulation in a living liver donor rat model. MATERIAL/METHODS Thirty-three animals were randomized into eleven groups and evaluated on postoperative from 3 h until 384 h after 30%-partial hepatectomy (30%-PHx). Liver sections (5 μm) were processed by hematoxylin-eosin, and immunostaining for C3, accompanied by hepatic function test. C3 content and the hepatic lobule enlargement were analyzed by optical density, followed by cell counting. RESULTS Transient variations of alanine transferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were found. Significant increase in the C3 levels, and cell nuclei number, were detected at 12 h and 48 h after 30%-PHx, evidencing a correlation of p = -0.3679. CONCLUSION In the 30%-PHx rat model, C3-related apoptosis prevents proliferative pathological conditions during the hepatic lobule re-modeling.
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Affiliation(s)
| | - Rasajna Nadella
- Department of Biosciences, Rajiv Gandhi University of Knowledge Technologies (RGUKT), Srikakulam, India
| | | | - Aurora Del Carmen Sánchez-García
- Laboratorio de Neuropatología Experimental, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, Mexico
| | - Laura Mireya Zavala-Flores
- Centro de Investigación Biomédica del Noreste, Instituto Mexicano del Seguro Social, Monterrey Nuevo León, Mexico
| | - Abraham Puga-Olguín
- Unidad de Salud Integrativa, Centro de EcoAlfabetización y Diálogo de Saberes, Universidad Veracruzana, Xalapa Veracruz, Mexico
| | - Arnulfo Villanueva-Olivo
- Departamento de Histología, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey Nuevo León, Mexico
| | - Daniel Hernandez-Baltazar
- Instituto de Neuroetología, Universidad Veracruzana, Xalapa Veracruz, Mexico; Cátedras CONACyT, Consejo Nacional de Ciencia y Tecnología (CONACYT), Mexico City, Mexico.
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Indocyanine green dye clearance test: early graft (dys)-function and long-term mortality after liver transplant. Should we continue to use it? An observational study. J Clin Monit Comput 2020; 35:505-513. [PMID: 32166552 DOI: 10.1007/s10877-020-00493-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 03/04/2020] [Indexed: 12/27/2022]
Abstract
Early allograft dysfunction (EAD) can be a serious complication in the immediate postoperative period following liver transplantation. Our aim was to study the prognostic role of the indocyanine green plasma disappearance rate (ICG-PDR) in predicting early and late EAD and mortality at 3 and 12 months and 5 years after liver transplantation. ICG-PDR values were also assessed for association with the Donor Risk Index (DRI). 220 patients underwent orthotopic liver transplantation. In 77 patients, ICG-PDR was assessed on the 1st post-operative (PO) day. ICG, a water-soluble dye almost entirely excreted into the bile, was measured by spectrophotometry to evaluate graft (dys)-function. DRI was calculated in all patients. The primary study outcomes were the presence (or absence) of EAD after transplant and the results of mortality risk factor analysis. EAD occurred in 18 patients. 1st PO day ICG-PDR was significantly associated with EAD (p < 0.005). A threshold ICG-PDR value < 16%/min on the 1st PO day was also associated with patient probability to survive at 3 and 12 months and 5 years. The sensitivity and specificity of the AUC was good in predicting EAD, being 83% and 56%, respectively, for a 1st PO day ICG-PDR cut-off value < 16%/min. In this study, ICG-PDR on the 1st PO day following OLT can reliably predict EAD and survival at 3 and 12 months and 5 years. ICG-PDR should, therefore, be routinely performed on the 1st PO day following OLTx in all patients in light of its important prognostic role.
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Fanelli V, Costamagna A, Carosso F, Rotondo G, Pivetta EE, Panio A, Cappello P, Mazzeo AT, Del Sorbo L, Grasso S, Mascia L, Brazzi L, Romagnoli R, Salizzoni M, Ranieri MV. Effects of liver ischemia-reperfusion injury on respiratory mechanics and driving pressure during orthotopic liver transplantation. Minerva Anestesiol 2018; 85:494-504. [PMID: 30394062 DOI: 10.23736/s0375-9393.18.12890-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND During orthotopic liver transplantation (OLT), liver graft ischemia-reperfusion injury (IRI) triggers a cytokine-mediated systemic inflammatory response, which impairs graft function and disrupts distal organ homeostasis. The objective of this prospective, observational trial was to assess the effects of IRI on lung and chest wall mechanics in the intraoperative period of patients undergoing OLT. METHODS In 26 patients undergoing OLT, we measured elastance of the respiratory system (ERS), partitioned into lung (EL) and chest wall (ECW), hemodynamics, and fluid and blood product intake before laparotomy (T1), after portal/caval surgical clamp (T2), and immediately (T3) and, at 90 and 180 minutes post-reperfusion (T4 and T5, respectively). Interleukin-6 (IL-6), monocyte chemotactic protein-1 (MCP-1), IL-1β and tumor necrosis factor-α plasma concentrations were assessed at T1, T4 and T5. RESULTS EL significantly decreased from T1 to T2 (13.5±4.4 vs 9.7±4.8 cmH2O/L, P<0.05), remained stable at T3, while at T4 (12.3±4.4 cmH2O/L, P<0.05) was well above levels recorded at T2, reaching its highest value at T5 (15±3.9 cmH2O/L, P<0.05). Variations in ERS, EL, driving pressure (∆P) and trans-pulmonary pressure (∆PL) significantly correlated with changes in IL-6 and MCP-1 plasma concentrations, but not with changes in wedge pressure, fluid amounts, and red blood cells and platelets administered. No correlation was found between changes in cytokine concentrations and ECW. CONCLUSIONS We found that EL, ECW, ∆P and ∆PL underwent significant variations during the OLT procedure. Further, we documented a significant association between the respiratory mechanics changes and the inflammatory response following liver graft reperfusion.
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Affiliation(s)
- Vito Fanelli
- Department of Anesthesia and Critical Care, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy - .,Department of Surgical Science, University of Turin, Turin, Italy -
| | - Andrea Costamagna
- Department of Anesthesia and Critical Care, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Fabio Carosso
- Department of Surgical Science, University of Turin, Turin, Italy
| | - Giuseppe Rotondo
- Department of Surgical Science, University of Turin, Turin, Italy
| | | | - Angelo Panio
- Department of Anesthesia and Critical Care, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Paola Cappello
- Laboratory of Tumor Immunology, Experimental Medicine Research Center (CeRMS), University of Turin, Turin, Italy
| | - Anna T Mazzeo
- Department of Anesthesia and Critical Care, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy.,Department of Surgical Science, University of Turin, Turin, Italy
| | - Lorenzo Del Sorbo
- Division of Respirology and Critical Care Medicine, Department of Medicine, Toronto General Hospital, University Health Network and Mount Sinai Hospital, Toronto, ON, Canada
| | - Salvatore Grasso
- Unit of Anesthesia and Intensive Care, Department of Emergency Medicine and Organ Transplant (DETO), University of Bari, Bari, Italy
| | - Luciana Mascia
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy
| | - Luca Brazzi
- Department of Anesthesia and Critical Care, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy.,Department of Surgical Science, University of Turin, Turin, Italy
| | - Renato Romagnoli
- Department of Surgical Science, University of Turin, Turin, Italy
| | - Mauro Salizzoni
- Department of Surgical Science, University of Turin, Turin, Italy
| | - Marco V Ranieri
- Department of Anesthesia and Intensive Care Medicine, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy
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Park M, Han S, Kim GS, Gwak MS. Evaluation of New Calibrated Pulse-Wave Analysis (VolumeViewTM/EV1000TM) for Cardiac Output Monitoring Undergoing Living Donor Liver Transplantation. PLoS One 2016; 11:e0164521. [PMID: 27736921 PMCID: PMC5063283 DOI: 10.1371/journal.pone.0164521] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 09/27/2016] [Indexed: 12/12/2022] Open
Abstract
Background Intrapulmonary thermodilution technique using a pulmonary artery catheter is widely used for measuring cardiac output (CO) in patients undergoing liver transplantation. However, its invasiveness and associated complications have led to an interest in less invasive modalities. Thus, we aimed to evaluate whether the new calibrated pulse-wave analysis method monitoring (VolumeViewTM/EV1000TM) is interchangeable with intrapulmonary thermodilution technique. Methods Twenty-eight patients undergoing living donor liver transplantation were enrolled in this prospective observational study. COs were recorded automatically by the two devices and compared simultaneously at 10-minute intervals. The agreement of absolute CO values and the tracking ability of CO changes trends were compared. A Bland-Altman analysis with percentage errors and concordance rate for trend analysis using both a 4-quadrant plot and a polar plot were performed on the data. Results A total of 375 paired datasets from 25 patients were included in analysis. COs measured by intrapulmonary thermodilution ranged from 3.8–13.7 L/min. The mean CO difference between the two techniques was 0.57 L/min, and the 95% limits of agreement were -0.98 L/min to 2.12 L/min with a percentage error of 42.3%. The percentage errors in the dissection, anhepatic, and reperfusion phase were 30.5%, 31.7%, and 27.4%, respectively. The concordance rate between the two techniques was 78.4%. Conclusion The calibrated pulse-wave analysis and intrapulmonary thermodilution failed to show acceptable interchangeability in terms of both estimating CO and tracking CO changes during living donor liver transplantation.
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Affiliation(s)
- MiHye Park
- Department of Anesthesiology and Pain Medicine, Kyungpook National University school of Medicine, Daegu, Republic of Korea
| | - Sangbin Han
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Gaab Soo Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Mi Sook Gwak
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- * E-mail:
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Konur H, Erdogan Kayhan G, Toprak HI, Bucak N, Aydogan MS, Yologlu S, Durmus M, Yılmaz S. Evaluation of pleth variability index as a predictor of fluid responsiveness during orthotopic liver transplantation. Kaohsiung J Med Sci 2016; 32:373-80. [PMID: 27450027 DOI: 10.1016/j.kjms.2016.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 05/18/2016] [Accepted: 05/25/2016] [Indexed: 11/17/2022] Open
Abstract
Fluid management is challenging and still remains controversial in orthotopic liver transplantation (OLT). The pleth variability index (PVI) has been shown to be a reliable predictor of fluid responsiveness of perioperative and critically ill patients; however, it has not been evaluated in OLT. This study was designed to examine whether the PVI can reliably predict fluid responsiveness in OLT and to compare PVI with other hemodynamic indexes that are measured using the PiCCO2 monitoring system. Twenty-five patients were enrolled in this study. Each patient was monitored using the noninvasive Masimo and PiCCO2 monitoring system. PVI was obtained with a Masimo pulse oximeter. Cardiac index was obtained using a transpulmonary thermodilution technique (CITPTD). Stroke volume variation (SVV), pulse pressure variation, and systemic vascular resistance index were measured using the PiCCO2 system. Fluid loading (10 mL/kg colloid) was performed at two different phases during the operation, and fluid responsiveness was defined as an increase in CITPTD ≥ 15%. During the dissection phase and the anhepatic phase, respectively, 14 patients (56%) and 18 patients (75%) were classified as responders. There were no differences between the baseline values of the PVI of responders and nonresponders. Area under the curve for PVI was 0.56 (sensitivity 35%, specificity 90%, p = 0.58) at dissection phase, and was 0.55 (sensitivity 55%, specificity 66%, p = 0.58) at anhepatic phase. Of the parameters, a higher area under the curve value was found for SVV. We conclude that PVI was unable to predict fluid responsiveness with sufficient accuracy in patients undergoing OLT, but the SVV parameter was reliable.
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Affiliation(s)
- Huseyin Konur
- Department of Anesthesiology and Reanimation, Goztepe Education and Research Hospital, Medeniyet University, Istanbul, Turkey
| | - Gulay Erdogan Kayhan
- Department of Anesthesiology and Reanimation, Inonu University Medical Faculty, Malatya, Turkey.
| | - Huseyin Ilksen Toprak
- Department of Anesthesiology and Reanimation, Inonu University Medical Faculty, Malatya, Turkey
| | - Nizamettin Bucak
- Department of Anesthesiology and Reanimation, Inonu University Medical Faculty, Malatya, Turkey
| | - Mustafa Said Aydogan
- Department of Anesthesiology and Reanimation, Inonu University Medical Faculty, Malatya, Turkey
| | - Saim Yologlu
- Department of Biostatistics, Inonu University Medical Faculty, Malatya, Turkey
| | - Mahmut Durmus
- Department of Anesthesiology and Reanimation, Inonu University Medical Faculty, Malatya, Turkey
| | - Sezai Yılmaz
- Department of General Surgery, Inonu University Medical Faculty, Malatya, Turkey
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Laight NS, Levin AI. Transcardiopulmonary Thermodilution-Calibrated Arterial Waveform Analysis: A Primer for Anesthesiologists and Intensivists. J Cardiothorac Vasc Anesth 2015; 29:1051-64. [PMID: 26279223 DOI: 10.1053/j.jvca.2015.03.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Indexed: 02/07/2023]
Affiliation(s)
- Nicola S Laight
- Department of Anesthesiology and Critical Care, University of Stellenbosch, Tygerberg Hospital, Cape Town, South Africa
| | - Andrew I Levin
- Department of Anesthesiology and Critical Care, University of Stellenbosch, Tygerberg Hospital, Cape Town, South Africa.
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Reydellet L, Blasco V, Mercier MF, Antonini F, Nafati C, Harti-Souab K, Leone M, Albanese J. Impact of a goal-directed therapy protocol on postoperative fluid balance in patients undergoing liver transplantation: a retrospective study. ACTA ACUST UNITED AC 2014; 33:e47-54. [PMID: 24456618 DOI: 10.1016/j.annfar.2013.12.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 12/18/2013] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Liver transplantation carries major risks during the perioperative period. Few studies focused on the hemodynamics of patients undergoing liver transplantation. The present study was aimed to evaluate the impact of the implementation of a protocol including goal-directed therapy in patients undergoing liver transplantation. Our first goal was to determine its impact on the fluid balance. Secondarily, we evaluated possible improvements in the patient outcomes. STUDY DESIGN A before and after study. PATIENTS AND METHODS Fifty patients undergoing liver transplantation were included during two successive six-month periods. During the first period, the management of the patients was left at the discretion of the senior physicians (control group, n=25). During the second period, the patients were treated according to a predetermined protocol including a specific hemodynamic monitoring (protocol group, n=25). RESULTS The fluid balance was negative in the protocol group and positive in the control group at 24h (-606mL vs. +3445mL, P<0.01) and 48h (-2315mL vs. +1170mL, P<0.01) after liver transplantation. The volume of the crystalloid administration was lower in the protocol group than in the control group (5000mL vs. 8000mL, P<0.01, and 1500mL vs. 6000mL, P<0.01, during surgery and 48h after liver transplantation, respectively). The duration of mechanical ventilation and postoperative ileus were significantly reduced in the protocol group, as compared with the control group, 20h vs. 94h (P<0.01) and 4days vs. 6days (P<0.01), respectively. CONCLUSION For patients undergoing liver transplantation, the implementation of a protocol aiming to optimize hemodynamics was associated with reduced fluid balance and decreased requirement for mechanical ventilation and postoperative ileus duration.
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Affiliation(s)
- L Reydellet
- Service d'anesthésie et de réanimation, hôpital de la Conception, Assistance publique-Hôpitaux de Marseille, 147, boulevard Baille, 13385 Marseille cedex 5, France; Aix-Marseille université, 13005 Marseille, France.
| | - V Blasco
- Service d'anesthésie et de réanimation, hôpital de la Conception, Assistance publique-Hôpitaux de Marseille, 147, boulevard Baille, 13385 Marseille cedex 5, France; Aix-Marseille université, 13005 Marseille, France
| | - M-F Mercier
- Service d'anesthésie et de réanimation, hôpital de la Conception, Assistance publique-Hôpitaux de Marseille, 147, boulevard Baille, 13385 Marseille cedex 5, France; Aix-Marseille université, 13005 Marseille, France
| | - F Antonini
- Aix-Marseille université, 13005 Marseille, France; Service d'anesthésie et de réanimation, hôpital Nord, Assistance publique-Hôpitaux de Marseille, chemin des Bourrely, 13915 Marseille cedex 20, France
| | - C Nafati
- Service d'anesthésie et de réanimation, hôpital de la Conception, Assistance publique-Hôpitaux de Marseille, 147, boulevard Baille, 13385 Marseille cedex 5, France; Aix-Marseille université, 13005 Marseille, France
| | - K Harti-Souab
- Service d'anesthésie et de réanimation, hôpital de la Conception, Assistance publique-Hôpitaux de Marseille, 147, boulevard Baille, 13385 Marseille cedex 5, France; Aix-Marseille université, 13005 Marseille, France
| | - M Leone
- Aix-Marseille université, 13005 Marseille, France; Service d'anesthésie et de réanimation, hôpital Nord, Assistance publique-Hôpitaux de Marseille, chemin des Bourrely, 13915 Marseille cedex 20, France
| | - J Albanese
- Service d'anesthésie et de réanimation, hôpital de la Conception, Assistance publique-Hôpitaux de Marseille, 147, boulevard Baille, 13385 Marseille cedex 5, France; Aix-Marseille université, 13005 Marseille, France
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