Influence of retrograde flushing via the caval vein on the post-reperfusion syndrome in liver transplantation.
BACKGROUND
The reperfusion phase during orthotopic liver transplantation (LTX) is a critical event with sometimes profound hemodynamic and cardiac changes. We present the influence of retrograde reperfusion in LTX on the post-reperfusion syndrome (PRS).


METHODS
Fifty-six LTXs in 53 patients were performed with the piggy-back technique with retrograde reperfusion via the caval vein and antegrade reperfusion via the portal vein. The incidence of PRS was evaluated.


RESULTS
We observed a PRS in two patients (3.6%), four patients (7.1%) had a decrease in mean arterial pressure (MAP) of 20-29%, 18 patients (32.2%) of 10-19%, 27 patients (48.2%) of 1-9% and five patients (8.9%) had a small increase in MAP.


CONCLUSIONS
Our retrospective study showed that retrograde reperfusion seems to maintain stability during the reperfusion phase. Hemodynamic disturbances during LTX were uncommon, leading us to suppose that the incidence of PRS could be diminished with retrograde reperfusion.
Daniela
Kniepeiss
K
Department of Surgery, Division of Transplantation, University Hospital Graz, Graz, Austria. daniela.kniepeiss@meduni-graz.at
Michael
Zink
Z
Florian
Iberer
I
Silvia
Schaffellner
S
Estrella
Jakoby
J
Doris
Duller
D
Karl-Heinz
Tscheliessnigg
T
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control*; D015424:Reperfusion / Q000009:adverse effects* / Q000379:methods*; D012189:Retrospective Studies; D013577:Syndrome; D014682:Vena Cava, Inferior