Daniela Kniepeiss, Michael Zink, Florian Iberer, Silvia Schaffellner, Estrella Jakoby, Doris Duller, Karl-Heinz Tscheliessnigg
Department of Surgery, Division of Transplantation, University Hospital Graz, Graz, Austria.
Clin Transplant. 2004 Dec;18(6):638-41. doi: 10.1111/j.1399-0012.2004.00231.x.
The reperfusion phase during orthotopic liver transplantation (LTX) is a critical event with sometimes profound hemodynamic and cardiac changes. We present the influence of retrograde reperfusion in LTX on the post-reperfusion syndrome (PRS).
Fifty-six LTXs in 53 patients were performed with the piggy-back technique with retrograde reperfusion via the caval vein and antegrade reperfusion via the portal vein. The incidence of PRS was evaluated.
We observed a PRS in two patients (3.6%), four patients (7.1%) had a decrease in mean arterial pressure (MAP) of 20-29%, 18 patients (32.2%) of 10-19%, 27 patients (48.2%) of 1-9% and five patients (8.9%) had a small increase in MAP.
Our retrospective study showed that retrograde reperfusion seems to maintain stability during the reperfusion phase. Hemodynamic disturbances during LTX were uncommon, leading us to suppose that the incidence of PRS could be diminished with retrograde reperfusion.
原位肝移植（LTX）期间的再灌注阶段是一个关键事件，有时会伴有深刻的血流动力学和心脏变化。我们阐述了肝移植中逆行再灌注对再灌注综合征（PRS）的影响。
对53例患者进行了56例肝移植手术，采用背驮式技术，通过腔静脉进行逆行再灌注，通过门静脉进行顺行再灌注。评估PRS的发生率。
我们观察到2例患者（3.6%）发生了PRS，4例患者（7.1%）平均动脉压（MAP）下降20 - 29%，18例患者（32.2%）下降10 - 19%，27例患者（48.2%）下降1 - 9%，5例患者（8.9%）MAP略有升高。
我们的回顾性研究表明，逆行再灌注似乎在再灌注阶段维持了稳定性。肝移植期间的血流动力学紊乱并不常见，这使我们推测逆行再灌注可能会降低PRS的发生率。
