Factors Associated With Postreperfusion Syndrome in Living Donor Liver Transplantation: A Retrospective Study

研究成果: ジャーナルへの寄稿総説査読

抄録

BACKGROUND: Postreperfusion syndrome (PRS) after portal vein reperfusion during liver transplantation (LT) has been reported to cause rapid hemodynamic changes and is associated with a prolonged postoperative hospital stay, renal failure, and increased mortality. Although there are some reports on risk factors for PRS in brain-dead donor LT, there are a few reports on those in living donor LT. Therefore, we retrospectively reviewed the factors associated with PRS to contribute to the anesthetic management so as to reduce PRS during living donor LT. METHODS: After approval by the ethics committee of our institution, 250 patients aged ≥20 years who underwent living donor LT at our institution between January 2013 and September 2018 were included in the study. A decrease in mean arterial pressure of ≥30% within 5 minutes after portal vein reperfusion was defined as PRS, and estimates and odds ratio (OR) for PRS were calculated using logistic regression. The backward method was used for variable selection in the multivariable analysis. RESULTS: Serum calcium ion concentration before reperfusion (per 0.1 mmol/L increase; OR, 0.74; 95% confidence interval (CI), 0.60-0.95; P <.001), preoperative echocardiographic left ventricular end-diastolic diameter (per 1-mm increase: OR, 0.90; 95% CI, 0.85-0.95; P <.001, men [versus women: OR, 2.45; 95% CI, 1.26-4.75; P =.008]), mean pulmonary artery pressure before reperfusion (restricted cubic spline, P =.003), anhepatic period (restricted cubic spline, P =.02), and graft volume to standard liver volume ratio (restricted cubic spline, P =.03) were significantly associated with PRS. CONCLUSIONS: In living donor LT, male sex and presence of small left ventricular end-diastolic diameter, large graft volume, and long anhepatic period are associated with PRS, and a high calcium ion concentration and low pulmonary artery pressure before reperfusion are negatively associated with PRS.

本文言語英語
ページ(範囲)354-361
ページ数8
ジャーナルAnesthesia and Analgesia
135
2
DOI
出版ステータス出版済み - 8月 1 2022

!!!All Science Journal Classification (ASJC) codes

  • 麻酔学および疼痛医療

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