Gajate Martín L, González C, Ruiz Torres I, Fernández Martín C, Martín Grande A, Elías Martín E, Parise Roux D, Del Rey Sánchez J M
Department of Anesthesiology and Intensive Care, Ramon y Cajal University Hospital, Madrid, Spain.
Department of Anesthesiology and Intensive Care, Ramon y Cajal University Hospital, Madrid, Spain.
Transplant Proc. 2016 Dec;48(10):3307-3311. doi: 10.1016/j.transproceed.2016.08.048.
Morbidity and mortality rates in orthotopic liver transplantation have decreased in the past few years. Risk factors related to severe postoperative complications, such as primary graft dysfunction, still need to be analyzed. We evaluated the influence of the hypnotic agent used during anesthesia on primary graft dysfunction.
We performed a retrospective analysis of 419 consecutive patients who received a liver transplant between 2005 and 2013 in a single center. We analyzed the incidence of primary graft dysfunction (defined as alanine aminotransferase or aspartate aminotransferase levels higher than 1500 IU/L on the first 3 days after surgery) and if the hypnotic agent was associated with this event.
The incidence of primary graft dysfunction was 42.2% (114 patients), similar in both groups (propofol group, 89 patients, 43.2% and sevoflurane group, 25 patients, 39.1%). In the multivariate analysis, we did not find any relationship between the hypnotic agent (propofol or sevoflurane) and early graft dysfunction.
In our patients, we found no differences in the incidence of liver graft dysfunction according to the hypnotic used during transplantation. We can suggest that both drugs (sevoflurane and propofol) are equally safe in orthotopic liver transplantation.
在过去几年中,原位肝移植的发病率和死亡率有所下降。与严重术后并发症相关的危险因素,如原发性移植肝功能障碍,仍需分析。我们评估了麻醉期间使用的催眠药物对原发性移植肝功能障碍的影响。
我们对2005年至2013年在单一中心接受肝移植的419例连续患者进行了回顾性分析。我们分析了原发性移植肝功能障碍的发生率(定义为术后前3天丙氨酸转氨酶或天冬氨酸转氨酶水平高于1500 IU/L)以及催眠药物是否与该事件相关。
原发性移植肝功能障碍的发生率为42.2%(114例患者),两组相似(丙泊酚组89例患者,43.2%;七氟醚组25例患者,39.1%)。在多变量分析中,我们未发现催眠药物(丙泊酚或七氟醚)与早期移植肝功能障碍之间存在任何关系。
在我们的患者中,根据移植期间使用的催眠药物,我们发现肝移植功能障碍的发生率没有差异。我们可以认为两种药物(七氟醚和丙泊酚)在原位肝移植中同样安全。