Post-Reperfusion Syndrome in Liver Transplantation—An Overview

Manning, Michael W.; Kumar, Priya A.; Maheshwari, Kamal; Arora, Harendra

doi:10.1053/j.jvca.2019.02.050

Cited by 44 publications

(33 citation statements)

References 84 publications

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“…Unlike other studies,[ 6 13 14 ] we did not find correlates with higher MELD, lower haemoglobin and creatinine with the occurrence of PRS. However, a lower pre-operative sodium (129.72 ± 7.55 vs. 132.47 ± 5.24, mEq/L, P = 0.024) in the PRS versus non-PRS group was seen in our study [ Figure 1 ].…”

Section: Discussioncontrasting

confidence: 99%

Correlation between radial and femoral arterial blood pressure during reperfusion in living donor liver transplantation

Thomas

Kumar

Jain

et al. 2021

Indian Journal of Anaesthesia

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Background and Aims: Accurate blood pressure measurements are the mainstay for the efficient management of abrupt cardiovascular changes during reperfusion in liver transplant. We sought to compare the femoral and radial pressures during reperfusion and at T1: baseline, T2: 1 h in dissection: T3: portosystemic shunt, T4: reperfusion, T5: at bile duct anastomosis. Methods: A retrospective study was performed amongst 102 adult patients who underwent R lobe living donor liver transplantation. Mean arterial pressure (MAP) and systolic arterial pressure (SAP) at 10 s intervals at reperfusion and at five fixed time points were compared by intraclass correlation coefficient (ICC) and limits of agreement by Bland–Altman statistics. Results: MAP by both routes had a good correlation at all time points during reperfusion (overall ICC: 0.946 [0.938, 0.949]) in comparison with SAP (overall ICC: 0.650 [0.6128, 0.684]). At the lowest reperfusion pressure (reperfusion point), MAP showed high levels of agreements (ICC: 0.833 [0.761, 0.885]), whereas SAP showed only a poor level of agreement (ICC 0.343 [0.153, 0.508]). The Bland–Altman analysis for MAP showed a bias of 7.18 (5.94) mmHg and limits of agreement of − 4.5 mmHg to + 18.8 mmHg and for SAP a bias of 25.2 (22.04) mmHg and limits of agreement of − 18.0 mmHg to + 68.4 mmHg at the reperfusion point. The incidence of post-reperfusion syndrome (PRS) was 52.94% by femoral and 57.84% by radial routes. Conclusions: Radial MAP correlated well with femoral MAP during reperfusion and at predefined time points and can be used interchangeably for intraoperative monitoring. A high incidence of PRS was noted by our technique of measurement.

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Section: Discussioncontrasting

confidence: 99%

Correlation between radial and femoral arterial blood pressure during reperfusion in living donor liver transplantation

Thomas

Kumar

Jain

et al. 2021

Indian Journal of Anaesthesia

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“…Orthotopic Liver transplantation (OLT) is a life-saving procedure and the treatment of choice for severe chronic liver disease and acute liver failure [ 1 , 2 ]. Post reperfusion syndrome (PRS) is a relatively common but life-threatening complication during OLT with a prevalence of 3.6–81% [ 3 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors of the post-reperfusion syndrome during orthotopic liver transplantation: a clinical observational study

et al. 2022

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Background Post reperfusion syndrome (PRS) is a relatively common and life-threatening complication during orthotopic liver transplantation (OLT). It is associated with poor patient and transplanted liver outcomes. Objective This study aimed to compare the risk factors of PRS during OLT. Design Clinical-epidemiological observational retrospective study. Setting We gathered the records of patients who underwent OLT in 3 years, from May 22, 2016, to May 22, 2019, in Namazi and Bu-Ali Sina organ transplantation hospitals. Patients In this study, we assessed 1182 patients who underwent OLT. Patients were divided into two groups based on the presence or absence of PRS. Main outcome measures Diagnosing the predictors of PRS was the primary outcome of this study. Results Results showed that age > 60 years, Child-Pugh scores C, higher Model End Stage liver disease score, and preoperative sodium < 130 mmol/l (parameters of the liver recipient), increase in cold ischemic time (the donors’ parameters), and the classical technique (the surgical parameters) were the strong predictors of PRS. Conclusions The results indicated that underlying liver disease was not the predictor of PRS in the presence of other risk factors; therefore, clinicians have to consider these risk factors in patients undergoing OLT.

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“…A hallmark of significant PRS is the need for vasopressor infusion intraoperatively. The incidence of PRS varies widely from as low as 8% to rates as high as 77% [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

The Use of Methylene Blue during Liver Transplantation for Vasoplegia

Harding

Nicholas

Kassel

2021

Case Reports in Anesthesiology

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The use of methylene blue for vasoplegia in cardiac cases with cardiopulmonary bypass, septic shock, and acute liver failure is well documented. Use of MB for liver transplantation has been largely limited to case reports. We describe three separate liver transplantation patients with significant hypotension following reperfusion. Administration of methylene blue to each patient resulted in a significant decrease in vasopressor medication and two patients weaned completely. We argue that the use of MB should be considered as a treatment option for refractory hypotension.

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Post-Reperfusion Syndrome in Liver Transplantation—An Overview

Cited by 44 publications

References 84 publications

Correlation between radial and femoral arterial blood pressure during reperfusion in living donor liver transplantation

Correlation between radial and femoral arterial blood pressure during reperfusion in living donor liver transplantation

Risk factors of the post-reperfusion syndrome during orthotopic liver transplantation: a clinical observational study

The Use of Methylene Blue during Liver Transplantation for Vasoplegia

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