Rapid and homogeneous reperfusion as a risk factor for postreperfusion syndrome during orthotopic liver transplantation.
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.
Cordoví de Armas
Lucas
L
Serviço de Anestesiologia, Hospital Clínico Quirúrgico Heramanos Ameijeiras. lucas@infomed.sld.cu
Jiménez Paneque
Rosa E
RE
Gala López
Boris
B
Rápalo Romero
Edin Ismael
EI
Añuez Castillo
Ydriss
Y
Vallongo Menéndez
Marina Beatriz
MB
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