title: Postreperfusion syndrome during orthotopic liver transplantation: a single-center experience.
abstract: BACKGROUND
  Marked hemodynamic alteration, commonly referred to as postreperfusion syndrome (PRS), often occurs after revascularization of the donor organ during orthotopic liver transplantation (OLT) and is associated with poor outcomes. This study aimed to investigate the incidence, predictive factors and clinical outcomes of PRS in Chinese patients following OLT at a liver transplantation center in China.
  
  
  METHODS
  Over a 5-year period, 330 consecutive patients who had undergone OLT for hepatocellular carcinoma or cirrhosis were included in this retrospective study. PRS was defined as a >30% decrease in the mean arterial pressure compared with that before revascularization for more than 1 minute during the first 5 minutes of graft reperfusion. The patients were divided into 2 groups according to the development of PRS: group 1 (patients with PRS, n=56) and group 2 (patients without PRS, n=274). The demographic characteristics, operative and postoperative courses, and outcomes of the patients were analyzed using SPSS version 18.0.
  
  
  RESULTS
  Multivariate regression analysis showed that left ventricular diastolic dysfunction determined by echocardiography and prolonged cold ischemia time were the independent risk factors for PRS. More patients in group 1 showed postoperative renal dysfunction than those in group 2 (19.23% vs 8.4%). Moreover, patients in group 1 also had higher intraoperative (7.14% vs 0%) and postoperative mortalities (26.92% vs 12.04%).
  
  
  CONCLUSIONS
  Left ventricular diastolic dysfunction and prolonged cold ischemia time contribute to a high incidence of PRS, which is associated with adverse outcomes in Chinese patients following OLT.
authors.affiliation: Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Zhen-Dong
authors.initials: ZD
authors.lastname: Xu
authors.forename: Hai-Tao
authors.initials: HT
authors.lastname: Xu
authors.forename: Hong-Bin
authors.initials: HB
authors.lastname: Yuan
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
authors.forename: Rui-Hua
authors.initials: RH
authors.lastname: Ji
authors.forename: Zui
authors.initials: Z
authors.lastname: Zou
authors.forename: Zhi-Ren
authors.initials: ZR
authors.lastname: Fu
authors.forename: Xue-Yin
authors.initials: XY
authors.lastname: Shi
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001794:Blood Pressure; D016009:Chi-Square Distribution; D002681:China; D050377:Cold Ischemia / Q000009:adverse effects; D005260:Female; D006439:Hemodynamics; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000503:physiopathology; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology