title: Incidence and predictors of post-reperfusion syndrome in living donor liver transplantation.
abstract: A characteristic pattern of hemodynamic changes that may occur in reperfusion phase of liver transplantation (LT) is known as post-reperfusion syndrome (PRS). In this study, we determined the frequency of PRS and evaluated possible predictors of PRS. The medical records of 152 patients who underwent living donor LT were reviewed. PRS was defined as a decrease in mean arterial pressure of more than 30% from the baseline value for more than one min during the first five min after reperfusion. The frequency of PRS was determined, and patients were divided into two groups: PRS group and non-PRS group. Donor factors, preoperative and intraoperative recipient factors, and postoperative outcomes were compared between the two groups. PRS occurred in 58 recipients (34.2%). Preoperative model for end-stage liver disease scores of recipients and percentage of graft steatotic changes were higher in PRS group. PRS group showed higher heart rates and lower hemoglobin values preoperatively. Before reperfusion, PRS group received more transfusion and their urine output was less than that of non-PRS group. Postoperatively, peak bilirubin during the first five d after LT was higher in PRS group. In conclusion, both severity of liver disease and graft steatosis may increase risk for PRS in LT. Further prospective studies of PRS in its relationship to outcome are indicated.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-Gu, Seoul, South Korea.
authors.forename: In S
authors.initials: IS
authors.lastname: Chung
authors.forename: Ha Y
authors.initials: HY
authors.lastname: Kim
authors.forename: Young H
authors.initials: YH
authors.lastname: Shin
authors.forename: Justin S
authors.initials: JS
authors.lastname: Ko
authors.forename: Mi S
authors.initials: MS
authors.lastname: Gwak
authors.forename: Woo S
authors.initials: WS
authors.lastname: Sim
authors.forename: Gaab S
authors.initials: GS
authors.lastname: Kim
authors.forename: Suk-Koo
authors.initials: SK
authors.lastname: Lee
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D015994:Incidence; D008107:Liver Diseases / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D015424:Reperfusion / Q000009:adverse effects*; D015427:Reperfusion Injury / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013577:Syndrome