title: Intraoperative Management and Postoperative Outcome in Intestine-Inclusive Liver Transplantation Versus Liver Transplantation.
abstract: BACKGROUND
  Although intestine-inclusive liver transplantation (IILT) is performed regularly, its perioperative management has not been studied extensively.
  
  
  METHODS
  Patients who underwent IILT and isolated liver transplantation (LT) at our center from January 2006 to December 2012 were identified. Among >1,000 LT patients, 90 were selected after matching by age, sex, surgery date, and status of preoperative ventilation for comparison with 45 IILT patients.
  
  
  RESULTS
  There were no significant differences regarding preoperative variables between the 2 groups except for international normalized ratio. However, IILT patients had significantly higher intraoperative requirement of blood transfusion, incidences of post-reperfusion syndrome, and hyperkalemia compared with LT patients. Postoperatively, IILT patients had significantly longer hospital stay and higher 1-year mortality. Multivariate analysis indicated that IILT was a primary risk factor associated with the studied complications and adverse outcomes.
  
  
  CONCLUSIONS
  Our findings suggest that, compared with LT patients, IILT patients were more prone to develop intraoperative complications and adverse outcomes and should be closely monitored and aggressively managed.
authors.affiliation: Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University of School of Medicine.
authors.forename: X
authors.initials: X
authors.lastname: Song
authors.affiliation: Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, California.
authors.forename: D G
authors.initials: DG
authors.lastname: Farmer
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California, Los Angeles, California. Electronic address: vxia@mednet.ucla.edu.
authors.forename: V W
authors.initials: VW
authors.lastname: Xia
mesh_terms: D000293:Adolescent; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000453:epidemiology / Q000209:etiology; D015994:Incidence; D019934:International Normalized Ratio; D007422:Intestines / Q000637:transplantation*; D007430:Intraoperative Care / Q000379:methods / Q000706:statistics & numerical data*; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000209:etiology; D007902:Length of Stay / Q000706:statistics & numerical data; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D015999:Multivariate Analysis; D016035:Pancreas Transplantation; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011184:Postoperative Period; D015427:Reperfusion Injury / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult