Incidence and indications for reintubation during postoperative care following orthotopic liver transplantation.
OBJECTIVE
To analyze the incidence and indications for reintubation during postoperative care following orthotopic liver transplantation (OLT).


METHODS
Retrospective chart review.


METHODS
Large metropolitan teaching hospital.


METHODS
546 adult liver transplant recipients.


RESULTS
The medical charts of 546 patients who underwent OLT at our institution between January 1992 and September 1996 were reviewed for the incidence and indications of reintubation throughout primary hospitalization. Eighty-one of 546 patients (14.8%) required one or more episodes of reintubation after OLT. In the majority of cases, reintubation was performed for pulmonary complications (44.6%), followed by cerebral (19.1%) and surgical (14.5%) complications. Cardiac (9.1%) and peripheral neurologic (2.7%) complications were less frequent reasons for reintubation. Overall patient survival, according to the Kaplan-Meier estimates, was 89.9%, 87.5%, 86.5%, and 82.2% after 1, 2, 3, and 5 years, respectively. In patients with one or more episodes of reintubation, overall survival decreased to 62.5% after 1, 2, and 3 years, and to 56.4% after 5 years (p < 0.001).


CONCLUSIONS
The main indications for reintubation after OLT were pulmonary, cerebral, and surgical complications. These reintubation events had a considerable influence on the patient's postoperative recovery, and were associated with a significantly higher rate of mortality, than for OLT patients who did not undo reintubation.
Glanemann
M
M
Department of General-, Visceral- & Transplantation Surgery, Charité, Campus Virchow Klinikum, Humboldt University Berlin, Germany. matthias.glanemann@charite.de
Kaisers
U
U
Langrehr
J M
JM
Schenk
R
R
Stange
B J
BJ
Müller
A R
AR
Bechstein
W O
WO
Falke
K
K
Neuhaus
P
P
D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007442:Intubation, Intratracheal; D016031:Liver Transplantation / Q000502:physiology*; D008991:Monitoring, Physiologic; D011182:Postoperative Care; D012129:Respiratory Function Tests; D012189:Retrospective Studies
D000890:Anti-Infective Agents; D007166:Immunosuppressive Agents