title: Effect of "the Awakening Protocol" in the outcome of liver transplantation.
abstract: OBJECTIVE
  To analyze mortality (7 days) or graft loss in liver transplantation (Tx) performed within the Awakening Protocol (AP) compared to sequential Tx.
  
  
  METHODS
  Analysis of 243 liver tx (230 patients), divided into sequential tx or PD (early morning) to compare graft loss or death (7 days). Significant differences at p < 0.05
  
  
  RESULTS
  The PD was adopted in 32.5% of tx. The cold ischemia time (p < 0.01) and the interval until transplantation (p < 0.01) were significantly different. Age of the donor and recipient, Donor Risk Index, MELD score, and donor base excess, sodium, creatinine and glucose were not different between groups. Previous abdominal surgery was a risk factor for early mortality, but was equally distributed between the groups. There was no difference in mortality or graft loss within 7 days (p = 0.521)
  
  
  CONCLUSIONS
  The adoption of PD, to start tx the morning when harvesting occurs after 10p.m. did not result in worse patient and graft survival. Transplant patients with fulminant hepatic failure and high-risk grafts do not apply to this surgical tactics.
authors: Department of Surgery, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte-MG, Brazil. agnaldo@gold.com.br
authors: Agnaldo Soares
authors: AS
authors: Lima
authors: Leandro Ricardo de Navarro
authors: LR
authors: Amado
authors: Malvina Maria de Freitas
authors: MM
authors: Duarte
authors: Marcelo Dias
authors: MD
authors: Sanches
authors: Alexandre Prado de
authors: AP
authors: Resende
authors: João Ricardo Miranda
authors: JR
authors: Zocrato
authors: Maria Eva Costa
authors: ME
authors: Zocrato
mesh_terms: D000328:Adult; D002985:Clinical Protocols; D050377:Cold Ischemia / Q000009:adverse effects; D005260:Female; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult