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Objective: To review the development of atrial fibrillation (AF) during the perioperative period (intraoperative and postoperative) in liver transplant recipients. Methods: This integrative review sought to analyze the emergence of AF in the perioperative period of liver transplantation and its associated factors. The following databases were used: PubMed, MEDLINE, SciELO, and Scopus. The descriptors were interchanged using the boolean operator “AND”, with a time restriction of 10 years, in English and Portuguese. Initially, 305 articles were found, of which nine met the proposed objective after analysis. Results: In this review, nine articles were selected, categorized according to the onset of AF concerning liver transplant surgery: three concerning the onset of AF in the intraoperative period and six in the postoperative period. During the intraoperative period, cases of AF had a higher incidence after reperfusion of the liver graft. In addition, the group with AF had a higher incidence of liver failure, a higher model for end-stage liver disease (MELD) scores, higher serum total bilirubin concentrations, and increased international normalized ratio (INR) values. AF in the postoperative period was associated with older patients, higher MELD scores, and renal dysfunction. Hospital stay was prolonged, and the risk of mortality was increased in patients with postoperative AF. Conclusion: The appearance of AF in the perioperative period of liver transplantation suggests a correlation with patients with higher MELD scores, advanced age, and instability during surgery and may indicate a poor prognosis for the patient.
Objective: To review the development of atrial fibrillation (AF) during the perioperative period (intraoperative and postoperative) in liver transplant recipients. Methods: This integrative review sought to analyze the emergence of AF in the perioperative period of liver transplantation and its associated factors. The following databases were used: PubMed, MEDLINE, SciELO, and Scopus. The descriptors were interchanged using the boolean operator “AND”, with a time restriction of 10 years, in English and Portuguese. Initially, 305 articles were found, of which nine met the proposed objective after analysis. Results: In this review, nine articles were selected, categorized according to the onset of AF concerning liver transplant surgery: three concerning the onset of AF in the intraoperative period and six in the postoperative period. During the intraoperative period, cases of AF had a higher incidence after reperfusion of the liver graft. In addition, the group with AF had a higher incidence of liver failure, a higher model for end-stage liver disease (MELD) scores, higher serum total bilirubin concentrations, and increased international normalized ratio (INR) values. AF in the postoperative period was associated with older patients, higher MELD scores, and renal dysfunction. Hospital stay was prolonged, and the risk of mortality was increased in patients with postoperative AF. Conclusion: The appearance of AF in the perioperative period of liver transplantation suggests a correlation with patients with higher MELD scores, advanced age, and instability during surgery and may indicate a poor prognosis for the patient.
Objetivo: Revisar o desenvolvimento da fibrilação atrial (FA) durante o período perioperatório (intra e pós-operatório) em receptores de transplante de fígado (TxF). Métodos: Trata-se de uma revisão integrativa que buscou analisar o surgimento da FA no perioperatório de transplante hepático, bem como seus fatores associados. Utilizaram-se as bases de dados PubMed, MEDLINE, SciELO e Scopus. Os descritores foram permutados utilizando o operador booleano “AND”, com a restrição temporal de 10 anos, nos idiomas inglês e português. Inicialmente, foram encontrados 305 artigos, dos quais nove atenderam ao objetivo proposto após a análise. Resultados: Nesta revisão, foram selecionados nove artigos, os quais foram categorizados de acordo com o momento de surgimento da FA, em relação à cirurgia de transplante hepático: três em relação ao surgimento da FA no intraoperatório (FAIO) e seis no pós-operatório. Durante o período intraoperatório, os casos de FA apresentaram maior incidência após a reperfusão do enxerto hepático. Além disso, o grupo com FA apresentou maior incidência de insuficiência hepática, pontuações mais altas no escore model for end-stage liver disease (MELD), concentrações séricas mais elevadas de bilirrubina total e valores aumentados de international normalized ratio (INR). A presença de FA no pós-operatório (FAPO) foi associada a pacientes de idade avançada, com escores MELD mais elevados e disfunção renal. A permanência hospitalar foi prolongada e o risco de mortalidade foi aumentado em pacientes com FAPO. Conclusão: O aparecimento da FA no perioperatório de transplante de fígado sugere uma correlação com pacientes de escores MELD mais altos, idade avançada e possibilidade de ocorrerem instabilidades hemodinâmicas, como arritmias durante a cirurgia, podendo indicar um mau prognóstico para o paciente.
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