title: [Influence of preoperative propranolol on cardiac index during the anhepatic phase of liver transplantation].
abstract: BACKGROUND
  Liver transplantation (LT) is the best therapeutic option for end-stage liver disease (ESLD). Non-selective beta-blocker medications such as propranolol act directly on the cardiovascular system (CVS) and are often used in the prevention of gastrointestinal bleeding resulting from HP. The effects of propranolol on CVS of cirrhotic patients during LT are not known.
  
  
  OBJECTIVE
  Evaluate the influence of propranolol used preoperatively on cardiac index (CI) during the anhepatic phase of LT.
  
  
  METHODS
  101 adult patients (73 male [72.2%]) who underwent cadaveric donor orthotopic liver transplantation by piggyback technique with preservation of the retrohepatic inferior vena cava performed at Hospital das Clinicas, Federal University of Minas Gerais were evaluated. There was no difference in severity between groups by the MELD system, p=0.70. The preoperative use of propranolol and the CI outcome were compared during the anhepatic phase of LT in 5 groups (I: increased CI, II: CI reduction lower than 16%, III: CI reduction equal to or greater than 16% and less than 31%, IV: CI reduction equal to or greater than 31% and less than 46%, V: CI reduction equal to or greater than 46%).
  
  
  RESULTS
  Patients in group I (46.4%) who received propranolol preoperatively were statistically similar to groups II (60%), III (72.7%), IV (50%) and V (30.8%), p=0.57.
  
  
  CONCLUSIONS
  The use of propranolol before transplantation as prophylaxis for gastrointestinal bleeding may be considered safe, as it was not associated with worsening of CI in anhepatic phase of LT.
authors.affiliation: Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil. Electronic address: seiberlich@gmail.com.
authors.forename: Emerson
authors.initials: E
authors.lastname: Seiberlich
authors.affiliation: Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil.
authors.forename: Marcelo D
authors.initials: MD
authors.lastname: Sanches
authors.affiliation: Hospital Life Center, Belo Horizonte, MG, Brasil.
authors.forename: Bruno S
authors.initials: BS
authors.lastname: Morais
authors.affiliation: Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil.
authors.forename: Jader F
authors.initials: JF
authors.lastname: Maciel
keywords: Antagonista adrenérgico beta; Beta‐adrenergic antagonist; Cardiac output; Débito cardíaco; Liver transplant; Propranolol; Transplante de fígado