Causes of postreperfusion syndrome in living or cadaveric donor liver transplantations.
OBJECTIVE
The postreperfusion syndrome (PRS) occurrence was evaluated in patients undergoing liver transplantation in our institution to determine the relationship between PRS and associated variables.


METHODS
Of the 185 consecutive liver transplants, pediatric patients, patients with uncompleted data or retransplantations were excluded. The remaining 145 adult patients having 77 cadaveric and 68 living donor right lobe liver transplantations were studied. PRS was defined as a decrease in mean arterial pressure >30% below the baseline value. Logistic regression was used for statistical analyses. A P value <.05 was considered as significant.


RESULTS
Total rate of PRS occurrence was 48.9% (71 patients) for the 145 patients. Logistic regression analyses revealed a significant relationship between the PRS and four of the variables: shorter duration of the anhepatic period, higher mean calcium requirement, higher mean heart rate difference from anhepatic to reperfusion period and lower central venous pressure at the dissection period during operations (P <.05). We could not demonstrate any significant effect of the operation type-surgical technique and duration of operations, blood and fresh frozen plasma volume transfused, demographic variables of the recipients, donor liver factors, other haemodynamic and metabolic variables at specific time periods (P >.05).


CONCLUSIONS
In conclusion, it is important that PRS does not seem to occur in a predictable manner in this study except for the increased calcium requirements during the operations in PRS experienced patients. The clinical parameters as graft ischemia time, the type of the operation, demographic variables of the recipient, hemodynamic or metabolic variables and transfusion needs during the operations seemed to have no contribution to PRS occurrence.
Ayanoglu
H O
HO
Department of Anesthesiology and Reanimation, Izmir, Turkey. ayanoglu@med.ege.edu.tr
Ulukaya
S
S
Tokat
Y
Y
D000328:Adult; D002102:Cadaver; D006439:Hemodynamics; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000379:methods* / Q000502:physiology; D019520:Living Donors; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D015427:Reperfusion Injury / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies; D014019:Tissue Donors