title: The evaluation of hemodynamic changes during the reperfusion phase in adult living donor liver transplantations: the role of cardiovascular problems.
abstract: OBJECTIVE
  This study sought to evaluate the hemodynamic changes of and to analyze the effects of coronary artery disease (CAD) as well as its risk factors on hemodynamic parameters during the reperfusion phase (RP) in adult living donor liver transplantation (ALDLT).
  
  
  METHODS
  This single-center retrospective study evaluated 154 adult patients being assessed from January 2001 to December 2013 for orthotopic liver transplantation (OLT). The patients were divided into separate groups according to the presence or absence of CAD and its risk factors, including diabetes, hypertension, dyslipidemia, smoking, sex, and age. The hemodynamic parameters were noted during the RP with respect to the patient files. The comparison of the groups and the effects of cardiovascular problems on hemodynamic parameters were statistically analyzed.
  
  
  RESULTS
  A decrease of more than 20% in systolic arterial pressure was seen in 16 (16.7%), 7 (43.8%), and 17 (40.5%) patients without CAD, with CAD, and with its high risk factors (>2), respectively (P < .05). Moreover, diastolic hypotension was seen in 59 (38.3%) patients during RP; of those, 10 (62.5%) had CAD and 19 (45.2%) had CAD high-risk factors. The decline in both systolic and diastolic arterial pressure was significantly correlated with the increased number of risk factors (P < .05).
  
  
  CONCLUSIONS
  RP in ALDLT remains an issue not only for the surgeons but also for the anesthesiologists. Clinicians should be aware of CAD and its risk factors before OLT and successful management of such problems are mandatory for hemodynamic stability during this formidable process.
authors.affiliation: Department of Anaesthesiology, Baskent University School of Medicine, Ankara, Turkey. Electronic address: drocude@yahoo.com.
authors.forename: A
authors.initials: A
authors.lastname: Ayhan
authors.affiliation: Department of Anaesthesiology, Baskent University School of Medicine, Ankara, Turkey.
authors.forename: C
authors.initials: C
authors.lastname: Araz
authors.affiliation: Department of Anaesthesiology, Baskent University School of Medicine, Ankara, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Komurcu
authors.affiliation: Department of Anaesthesiology, Baskent University School of Medicine, Ankara, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Kaplan
authors.affiliation: Department of Anaesthesiology, Baskent University School of Medicine, Ankara, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Torgay
authors.affiliation: Department of General Surgery, Baskent University School of Medicine, Ankara, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology; D003971:Diastole; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007022:Hypotension / Q000453:epidemiology*; D007431:Intraoperative Complications / Q000453:epidemiology*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015424:Reperfusion; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D013599:Systole