title: Rapid and homogeneous reperfusion as a risk factor for postreperfusion syndrome during orthotopic liver transplantation.
abstract: OBJECTIVE
  The revascularization of the graft remains as a crucial instant of the orthotopic liver transplantation (OLT) surgical procedure. About a third of the recipients suffer the postreperfusion syndrome (PRS), a combination of hypothermia, metabolic disorders and cardiovascular instability potentially leading to cardiac arrest. The objective of this study was to evaluate the speed-quality (SQR) of the graft;s reperfusion as an independent predictor of PRS.
  
  
  METHODS
  All eligible patients receiving an OLT in our institution from 1987 to march 2009 were included. The adjusted OR for SQR-PRS association was obtained by means of logistic regression modeling including eight potential confounders.
  
  
  RESULTS
  The proportion of recipients suffering PRS was highest when the SQR was identified as good (75.8%) compared to those with middle or poor SQR; the relative risk comparing good SQR with poor SQR was 12.9 (CI 95%: 2.1-528.8). The adjusted OR was 132.9 (95% CI: 10.5-1688.6) when comparing good with bad SQR and 90.9 (95% CI: 13.8-645.2) when comparing good with intermediate SQR.
  
  
  CONCLUSIONS
  According to our results, SQR can be considered an unambiguous predictor of PRS.
authors.affiliation: Serviço de Anestesiologia, Hospital Clínico Quirúrgico Heramanos Ameijeiras. lucas@infomed.sld.cu
authors.forename: Lucas
authors.initials: L
authors.lastname: Cordoví de Armas
authors.forename: Rosa E
authors.initials: RE
authors.lastname: Jiménez Paneque
authors.forename: Boris
authors.initials: B
authors.lastname: Gala López
authors.forename: Edin Ismael
authors.initials: EI
authors.lastname: Rápalo Romero
authors.forename: Ydriss
authors.initials: Y
authors.lastname: Añuez Castillo
authors.forename: Marina Beatriz
authors.initials: MB
authors.lastname: Vallongo Menéndez
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015424:Reperfusion / Q000009:adverse effects* / Q000379:methods*; D015427:Reperfusion Injury / Q000209:etiology*; D012307:Risk Factors; D013577:Syndrome; D013997:Time Factors