title: Intra-operative cardiac arrests during liver transplantation - a retrospective review of the first 15 yr in Asian population.
abstract: Although many report intra-operative cardiac arrests (ICAs) in liver transplantation (LT), the incidence, major causes, and outcome remain unclear. We aimed to investigate retrospectively, the incidence, nature, and outcome of ICA in Asian population and to identify risk factors for ICA. Consecutive 1071 LTs in an institution during 1996-2011 (adult 920, pediatric 151/living donor liver transplantation, LDLT 841, deceased donor liver transplantation, DDLT 230) were reviewed. ICA occurred in 14 adult LTs (1.5%), but none in pediatrics. ICA occurred 1.0% and 3.3% in LDLT and DDLT, respectively. Stages of ICA incidence were three at pre-anhepatic, one at anhepatic, and 10 at neohepatic stage. Post-reperfusion syndrome (PRS) with hyperkalemia and bleeding were the major causes of ICA. While LDLT showed miscellaneous causes for ICA at various stages, DDLT incurred ICAs at neohepatic stage only. Interestingly, we did not find pulmonary thromboembolism (PTE) to incur ICA. Risk factor analysis showed no association of pre-operative patient condition, donor types, and intra-operative parameters. In this review, the incidence of ICA was low in Asian population with LDLT predominance, and while PTE was not the cause of ICA, the neohepatic stage with PRS and bleeding was the most vulnerable period to anticipate ICA.
authors: Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea.
authors: Sang Hyun
authors: SH
authors: Lee
authors: Mi Sook
authors: MS
authors: Gwak
authors: Soo Joo
authors: SJ
authors: Choi
authors: Young Hee
authors: YH
authors: Shin
authors: Justin Sangwook
authors: JS
authors: Ko
authors: Gaab Soo
authors: GS
authors: Kim
authors: Suk Young
authors: SY
authors: Lee
authors: Myung Hee
authors: MH
authors: Kim
authors: Hui Gyeong
authors: HG
authors: Park
authors: Suk-Koo
authors: SK
authors: Lee
authors: Hee Jung
authors: HJ
authors: Jeon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000401:mortality; D019520:Living Donors; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D055815:Young Adult