title: Complications related to invasive hemodynamic monitors during adult liver transplantation.
abstract: The rate of complications directly related to invasive monitors during liver transplantation (LT) was reviewed in 1206 consecutive adult LTs performed over 8.6 yr (1/1/2004-7/31/2012). The designated anesthesiologists placed intra-operative monitors, including two arterial catheters (via the radial and the right femoral arteries), central venous catheters (a 9 Fr. catheter and an 18 Fr. veno-venous bypass [VVB] return cannula in an internal jugular vein), a pulmonary artery catheter, and a transesophageal echocardiography (TEE) probe. A 17 Fr. VVB drainage cannula was placed via the left femoral vein. No Clavien-Dindo Grade V (death) or Grade IV (organ dysfunction) complication was identified. Nine Grade III complications (requiring surgical intervention) and 15 Grade II complications (conservative treatment) were noted. Seven (0.58% in 1206 cases) were related to a femoral arterial line with Grade III of four; seven (0.58%) were due to VVB return cannula in the femoral vein with Grade III of one; four (0.33%) were related to central venous catheters with Grade III of two; four (0.33%) were due to a TEE probe with Grade III of two; and two minor complications (0.17%) that were related to a radial arterial line. No complication was observed with a pulmonary arterial catheter. Current invasive monitors placed during LT have an acceptable risk.
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Shu Y
authors.initials: SY
authors.lastname: Lu
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsusaki
authors.forename: Ezeldeen
authors.initials: E
authors.lastname: Abuelkasem
authors.forename: Mark L
authors.initials: ML
authors.lastname: Sturdevant
authors.forename: Abhinav
authors.initials: A
authors.lastname: Humar
authors.forename: Ibtesam A
authors.initials: IA
authors.lastname: Hilmi
authors.forename: Raymond M
authors.initials: RM
authors.lastname: Planinsic
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Sakai
mesh_terms: D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D007431:Intraoperative Complications; D017093:Liver Failure / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors
keywords: Clavien-Dindo classification; Intra-operative hemodynamic monitors; arterial line; central venous line; liver transplantation; postoperative complications; transesophageal echocardiography; veno-venous bypass