Department of Anesthesiology and Reanimation, Gaziosmanpasa Hospital, Istanbul Yeni Yuzyil University Faculty of Medicine, 34010 Istanbul, Turkey.
Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, 44280 Istanbul, Turkey.
Medicina (Kaunas). 2024 Jul 16;60(7):1142. doi: 10.3390/medicina60071142.
: To evaluate the effects of the pulse index continuous cardiac output and MostCare Pressure Recording Analytical Method hemodynamic monitoring systems on short-term graft and patient outcomes during living donor liver transplantation in adult patients. : Overall, 163 adult patients who underwent living donor liver transplantation between January 2018 and March 2022 and met the study inclusion criteria were divided into two groups based on the hemodynamic monitoring systems used during surgery: the MostCare Pressure Recording Analytical Method group ( = 73) and the pulse index continuous cardiac output group ( = 90). The groups were compared with respect to preoperative clinicodemographic features (age, sex, body mass index, graft-to-recipient weight ratio, and Model for End-stage Liver Disease score), intraoperative clinical characteristics, and postoperative biochemical parameters (aspartate aminotransferase, alanine aminotransferase, total bilirubin, direct bilirubin, prothrombin time, international normalized ratio, and platelet count). : There were no significant between-group differences with respect to recipient age, sex, body mass index, graft-to-recipient weight ratio, Child, Model for End-stage Liver Disease score, ejection fraction, systolic pulmonary artery pressure, surgery time, anhepatic phase, cold ischemia time, warm ischemia time, erythrocyte suspension use, human albumin use, crystalloid use, urine output, hospital stay, and intensive care unit stay. However, there was a significant difference in fresh frozen plasma use ( < 0.001) and platelet use ( = 0.037). : The clinical and biochemical outcomes are not significantly different between pulse index continuous cardiac output and MostCare Pressure Recording Analytical Method as hemodynamic monitoring systems in living donor liver transplantation. However, the MostCare Pressure Recording Analytical Method is more economical and minimally invasive.
: 评估脉搏指数连续心输出量和 MostCare 压力记录分析方法血流动力学监测系统对成人活体肝移植中短期移植物和患者预后的影响。 : 总体而言,2018 年 1 月至 2022 年 3 月期间接受活体肝移植且符合研究纳入标准的 163 例成年患者根据术中使用的血流动力学监测系统分为两组:MostCare 压力记录分析方法组(n = 73)和脉搏指数连续心输出量组(n = 90)。比较两组患者术前临床特征(年龄、性别、体重指数、供肝与受体体重比、终末期肝病模型评分)、术中临床特征和术后生化参数(天冬氨酸转氨酶、丙氨酸转氨酶、总胆红素、直接胆红素、凝血酶原时间、国际标准化比值和血小板计数)。 : 两组患者在受体年龄、性别、体重指数、供肝与受体体重比、Child 评分、终末期肝病模型评分、射血分数、收缩压肺动脉、手术时间、无肝期、冷缺血时间、热缺血时间、红细胞悬液使用、人血白蛋白使用、晶体液使用、尿量、住院时间和重症监护病房停留时间方面无显著差异。然而,在新鲜冷冻血浆使用(<0.001)和血小板使用(=0.037)方面存在显著差异。 : 在活体肝移植中,脉搏指数连续心输出量和 MostCare 压力记录分析方法作为血流动力学监测系统,其临床和生化结局无显著差异。然而,MostCare 压力记录分析方法更经济且微创。