title: Orthotopic liver transplantation without venovenous bypass: 125 cases from a single center.
abstract: OBJECTIVE
  This study analyzed a 10-year single-center experience in orthotopic liver transplantation (OLT) without venovenous bypass (VVB).
  
  
  METHODS
  We retrospectively analysed a nonrandomized series (1999-2008) of 125 adult OLT patients without VVB.
  
  
  RESULTS
  The main causes of liver failure were viral hepatitis (n = 39), alcoholic liver disease (n = 22), and liver cancer (n = 17). One-year survival was 76.4%. The most common postoperative complications were bile duct stenosis (n = 12), postoperative bleeding (n = 8), hepatic artery thrombosis (n = 7), and primary liver failure (n = 6). Twelve patients required hemodialysis and four underwent retransplantations of the liver. Fourteen patients died before postoperative day 30(th). Univariate analysis showed significant differences between patients who did and did not survive 30 days among donor death diagnoses (P = .05), red blood cell units transfused (P = .03), aspartate aminotranferase on the first postoperative day (P = .002), ABO type (P = .04), time of orotracheal intubation (P = .001), hemodialysis (P = .001), and period of postoperative vasoactive drug use (P = .006). The total length of orotracheal tube intubation showed a significant independent association with mortality before 30 days (P < .001).
  
  
  CONCLUSIONS
  OLT without VVB can be safely performed even in severe cases of chronic liver failure.
authors.affiliation: Department of Surgery and Liver Transplantation, Oswaldo Cruz University Hospital, University of Pernambuco, Brazil. lecmiranda@gmail.com
authors.forename: L E C
authors.initials: LE
authors.lastname: Miranda
authors.forename: P S V
authors.initials: PS
authors.lastname: de Melo
authors.forename: B D
authors.initials: BD
authors.lastname: Sabat
authors.forename: A L
authors.initials: AL
authors.lastname: Tenório
authors.forename: D L
authors.initials: DL
authors.lastname: Lima
authors.forename: O C L F
authors.initials: OC
authors.lastname: Neto
authors.forename: A G
authors.initials: AG
authors.lastname: Amorim
authors.forename: J L
authors.initials: JL
authors.lastname: Fernandez
authors.forename: F I B
authors.initials: FI
authors.lastname: de Macedo
authors.forename: C M
authors.initials: CM
authors.lastname: Lacerda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D001938:Brazil; D002648:Child; D005260:Female; D006498:Hepatectomy; D006503:Hepatic Veins / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007442:Intubation, Intratracheal; D053208:Kaplan-Meier Estimate; D017093:Liver Failure / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy; D006435:Renal Dialysis; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D014682:Vena Cava, Inferior / Q000601:surgery*; D055815:Young Adult