title: Temporary porto-caval shunt utility during orthotopic liver transplantation.
abstract: BACKGROUND
  In liver transplantation (OLT) a porto-caval shunt is a well-defined technique practiced by many surgeons in several centers.
  
  
  METHODS
  We considered 186 cadaveric OLT patients who underwent a cavo-cavostomy-type reconstruction; they were divided into two groups: those in whom we performed a porto-caval shunt (group A) and those in whose we did not (group B). We evaluated several variables: warm and total ischemia time, intraoperative blood and fresh frozen plasma transfusions, crystalloid and colloid requirements, blood loss, operative duration, hemodynamic intraoperative changes and diuresis, length of hospital stay, and creatinine values at days 1 and 2, and at discharge day.
  
  
  RESULTS
  Total and warm ischemic time differed significantly between the two groups. Infusion of blood, fresh frozen plasma, colloid, and crystalloid did not significantly differ. Blood loss was lower, and intraoperative diuresis was not significantly increased in group A subjects. Postoperative hospitalizations were 16.5 and 17.8 days and operative times, 504 and 611 minutes in the two groups. Both cardiac index and ejection fraction values during the anhepatic phase were significantly greater among group A than group B patients. PAD at the two phases was greater in group B. The PAS was significantly different only at reperfusion time. Creatinine values were significantly different at discharge. Better survival was shown for group A patients over group B subjects.
  
  
  CONCLUSIONS
  The results presented herein confirmed that a porto-caval shunt during OLT was a safe, useful expedient contributing to an improved hemodynamic status and a better time distribution in the various phases of liver transplantation.
authors.affiliation: Liver and Multivisceral Transplant Center, University of Modena, Modena, Italy.
authors.forename: G D
authors.initials: GD
authors.lastname: Arzu
authors.forename: N
authors.initials: N
authors.lastname: De Ruvo
authors.forename: R
authors.initials: R
authors.lastname: Montalti
authors.forename: M
authors.initials: M
authors.lastname: Masetti
authors.forename: B
authors.initials: B
authors.lastname: Begliomini
authors.forename: F
authors.initials: F
authors.lastname: Di Benedetto
authors.forename: G
authors.initials: G
authors.lastname: Rompianesi
authors.forename: S
authors.initials: S
authors.lastname: Di Sandro
authors.forename: N
authors.initials: N
authors.lastname: Smerieri
authors.forename: G
authors.initials: G
authors.lastname: D'Amico
authors.forename: E
authors.initials: E
authors.lastname: Vezzelli
authors.forename: R M
authors.initials: RM
authors.lastname: Iemmolo
authors.forename: A
authors.initials: A
authors.lastname: Romano
authors.forename: R
authors.initials: R
authors.lastname: Ballarin
authors.forename: G P
authors.initials: GP
authors.lastname: Guerrini
authors.forename: M G
authors.initials: MG
authors.lastname: De Blasiis
authors.forename: M
authors.initials: M
authors.lastname: Spaggiari
authors.forename: G E
authors.initials: GE
authors.lastname: Gerunda
mesh_terms: D016063:Blood Loss, Surgical; D002102:Cadaver; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007432:Intraoperative Period; D016031:Liver Transplantation / Q000379:methods*; D018579:Patient Selection; D011167:Portacaval Shunt, Surgical / Q000379:methods*; D012189:Retrospective Studies; D012449:Safety; D014019:Tissue Donors