title: The occurrence of postreperfusion syndrome in orthotopic liver transplantation and its significance in terms of complications and short-term survival.
abstract: BACKGROUND
  Postreperfusion syndrome (PRS) is a state of significant hemodynamic instability following graft reperfusion during orthotopic liver transplantation (OLTx). We aimed to investigate its risk factors and influence on patient outcome based on a single centre's experience.
  
  
  METHODS
  A retrospective study on a group of 340 patients undergoing OLTx during the period 2005-2008 was conducted. Piggy-back technique was employed in 266 cases and classical technique in 64. PRS was defined as a decrease in mean arterial pressure greater than 30% below the baseline for a minimum of 1 minute during first 5 minutes of the reperfusion. Logistic regression analysis, Mann-Whitney test and 2-sample proportion test were used. P<0.05 was considered statistically significant.
  
  
  RESULTS
  PRS occurred in 12.1% of patients. We observed correlations between PRS and the following: longer cold ischemia time, operation with classical technique, longer duration of the operation, higher intraoperative erythrocytal mass (EM) and fresh frozen plasma (FFP) requirements, more frequent early post-operative complications, and lower 1-year survival. Retransplantation was needed nearly twice as often in the PRS-group, but the correlation was not statistically significant (the group was very small, as only 8 patients requested re-OLTx). The study did not demonstrate any statistically significant relationship between PRS and donors' age, recipients' age or sex, duration of the hospitalization, and occurrence of complications after discharge.
  
  
  CONCLUSIONS
  PRS occurrence seems to be associated with higher mortality rate and worse patient outcome. The study revealed a few risk factors that could be relevant in the prevention of PRS.
authors.affiliation: Students' Scientific Group of the Department of General, Transplantation and Liver Surgery, Medical University of Warsaw, Poland. b.bukowicka@gmail.com
authors.forename: Barbara
authors.initials: B
authors.lastname: Bukowicka
authors.forename: Rami Abi
authors.initials: RA
authors.lastname: Akar
authors.forename: Anna
authors.initials: A
authors.lastname: Olszewska
authors.forename: Piotr
authors.initials: P
authors.lastname: Smoter
authors.forename: Marek
authors.initials: M
authors.lastname: Krawczyk
mesh_terms: D000328:Adult; D050377:Cold Ischemia / Q000009:adverse effects / Q000401:mortality*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality*; D008297:Male; D015424:Reperfusion / Q000009:adverse effects / Q000401:mortality*; D015427:Reperfusion Injury / Q000209:etiology / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors