Fakhar Nasir, Chavoshi Khamneh Abdolhamid, Najafi Atabac, Sharifi Ali, Hyder Zeeshan, Salimi Javad
Liver Transplantation Research Centre, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
General Surgery Department, Hamadan University of Medical Sciences, Hamedan, Iran.
Gastroenterol Hepatol Bed Bench. 2020 Winter;13(1):50-56.
This study aimed to evaluate the impact of two different reperfusion techniques on outcomes of LT patients.
Post-reperfusion syndrome (PRS) during liver transplantation (LT) remains a serious issue for both the surgeon and anesthetist.
In this prospective study, all liver transplant recipients referred to the liver transplantation department of Imam Khomeini Hospital, Tehran, Iran, from January 2016 to June 2017 were enrolled in the study and were divided into two groups of vented (reperfusion with 300cc blood venting) and non-vented (reperfusion without blood venting) cases. Then, 30-minute intraoperative hemodynamic and biochemical changes, as well as 2-month complications and 6-month mortality, were compared between the groups.
57 LT cases (31 vented and 26 non-vented) were studied (50.9% female). The two groups had a similar age (p = 0.107), sex (p = 0.885), MELD score (p = 0.61), donor warm ischemic time (p = 0.85), recipient warm ischemic time (p = 0.36), cold ischemic time (p = 0.99), comorbid disease (p = 0.502), and etiology of end-stage liver disease (p = 0.281). PRS occurred in 3 (11.5%) patients in the vented group and 4 (12.9%) in the non-vented group (p = 0.69). One (3.8%) patient in the non-vented group and 4 (12.9%) patients in vented group died (p = 0.229).
Reperfusion with and without blood venting had the same outcome regarding intraoperative hemodynamic and biochemical changes, PRS rate, and postoperative complications, as well as 6-month survival. Thus, it seems that blood venting is not a necessary method for decreasing post-reperfusion complications following LT.
本研究旨在评估两种不同的再灌注技术对肝移植患者预后的影响。
肝移植（LT）期间的再灌注综合征（PRS）对外科医生和麻醉师来说仍然是一个严重问题。
在这项前瞻性研究中，2016年1月至2017年6月转诊至伊朗德黑兰伊玛目霍梅尼医院肝移植科的所有肝移植受者均纳入本研究，并分为排气组（用300cc血液排气进行再灌注）和非排气组（无血液排气进行再灌注）。然后，比较两组术中30分钟的血流动力学和生化变化，以及2个月的并发症和6个月的死亡率。
研究了57例肝移植病例（31例排气组和26例非排气组）（50.9%为女性）。两组在年龄（p = 0.107）、性别（p = 0.885）、终末期肝病模型（MELD）评分（p = 0.61）、供体热缺血时间（p = 0.85）、受体热缺血时间（p = 0.36）、冷缺血时间（p = 0.99）、合并疾病（p = 0.502）和终末期肝病病因（p = 0.281）方面相似。排气组3例（11.5%）患者和非排气组4例（12.9%）患者发生PRS（p = 0.69）。非排气组1例（3.8%）患者和排气组4例（12.9%）患者死亡（p = 0.229）。
有无血液排气的再灌注在术中血流动力学和生化变化、PRS发生率、术后并发症以及6个月生存率方面具有相同的结果。因此，似乎血液排气不是降低肝移植后再灌注并发症的必要方法。
