The safety of transesophageal echocardiography in patients undergoing orthotopic liver transplantation

Abstract

Objective: To evaluate the safety of transesophageal echocardiography for the evaluation and intraoperative monitoring of patients during orthotopic liver transplantation.

Design: Retrospective observational study.

Setting: Tertiary care, university teaching hospital.

Participants: Patients (n = 116) who underwent intraoperative transesophageal echocardiography during liver transplantation.

Interventions: Intraoperative transesophageal echocardiography during liver transplantation.

Measurements and main results: The authors evaluated the safety of intraoperative transesophageal echocardiography in patients undergoing liver transplantation through a retrospective chart review. Complications associated with transesophageal echocardiography use were divided into minor and major complications. Out of 116 patients who underwent intraoperative transesophageal echocardiography, there was one minor and one major complication. The major complication rate was 0.86% (1/116) and the overall complication rate was 1.7% (2/116). There was no statistically significant correlation between pre-transplant sclerotherapy for treatment of varices and intraoperative transesophageal echocardiography-related gastrointestinal bleeding. Although the reported complication rate is higher than what has been quoted in the cardiac literature, intraoperative transesophageal echocardiography during liver transplantation has a low complication rate.

Conclusions: Intraoperative transesophageal echocardiography is a relatively safe method of monitoring cardiac performance in liver transplant patients.

Keywords: efficacy; gastrointestinal bleeding; liver transplantation; safety; transesophageal echocardiography; utility.