title: Post-operative hypertension, a surrogate marker of the graft function and predictor of survival in living donor liver transplant recipients: A retrospective study.
abstract: OBJECTIVE
  De novo hypertension (HTN) in liver transplantation recipients is a known entity. We investigated haemodynamic behaviour after a liver transplant to see if it can predict survival to discharge from the hospital.
  
  
  METHODS
  electronic records of Haemodynamic parameters and laboratory investigations of 95 patients of living donor liver transplant (LDLT) were retrospectively analysed.
  
  
  RESULTS
  Twenty-three patients were operated for acute liver failure (ALF) and 72 patients for chronic liver disease (CLD). Eight patients of CLD and four of ALF did not survive. CLD patients had statistically significant rise in systolic blood pressure from the post-operative day (POD) 1 to POD 4 and diastolic blood pressure (DBP) from POD 3 to POD 6. Heart rate (HR) significantly decreased from POD 3 to POD 5. Haemodynamic parameters returned to baseline values within 20 days. Diastolic HTN had a positive predictive value of 100% for survival with 100% sensitivity and specificity. Systolic HTN had a positive predictive value of 100% for survival (sensitivity-89%, specificity-100%). ALF patients had a significant decrease in HR from POD 2 to POD 10. Bradycardia (HR ≤60/min) had a positive predictive value of 100% for survival with a sensitivity of 45% and 58% in CLD and ALF, respectively, with a specificity of 100% in both the groups. Non-survivors had no significant change in haemodynamics. In CLD group, International Normalised Ratio had statistically significant, strong negative correlation with DBP.
  
  
  CONCLUSIONS
  Haemodynamic pattern of recovery may be used for predicting survival to discharge after LDLT.
authors: Department of Anaesthesia and Critical Care, Institute of Liver and Biliary Sciences, New Delhi, India.
authors: Manish
authors: M
authors: Tandon
authors: Department of Anaesthesia and Critical Care, Institute of Liver and Biliary Sciences, New Delhi, India.
authors: Anshuman
authors: A
authors: Singh
authors: Department of Anaesthesia and Critical Care, Institute of Liver and Biliary Sciences, New Delhi, India.
authors: Vandana
authors: V
authors: Saluja
authors: Department of Anaesthesia and Critical Care, Institute of Liver and Biliary Sciences, New Delhi, India.
authors: Gaurav
authors: G
authors: Dubey
authors: Department of Anaesthesia and Critical Care, Institute of Liver and Biliary Sciences, New Delhi, India.
authors: Vijay Kant
authors: VK
authors: Pandey
authors: Department of Anaesthesia and Critical Care, Institute of Liver and Biliary Sciences, New Delhi, India.
authors: Chandra Kant
authors: CK
authors: Pandey
authors: Department of Anaesthesia and Critical Care, Institute of Liver and Biliary Sciences, New Delhi, India.
authors: Sunaina Tejpal
authors: ST
authors: Karna
authors: Department of Anaesthesia and Critical Care, Institute of Liver and Biliary Sciences, New Delhi, India.
authors: Shweta A
authors: SA
authors: Singh
keywords: Diastolic hypertension; living donor liver transplantation; post-liver transplantation; systolic hypertension