Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Winter;13(1):50-56.

Impact of reperfusion with blood venting on liver transplantation outcomes; a prospective case-control study

Nasir Fakhar  1 , Abdolhamid Chavoshi Khamneh  1 , Atabac Najafi  1 , Ali Sharifi  1   2 , Zeeshan Hyder  1 , Javad Salimi  1
Affiliations

Impact of reperfusion with blood venting on liver transplantation outcomes; a prospective case-control study

Nasir Fakhar et al. Gastroenterol Hepatol Bed Bench. 2020 Winter.

Abstract

Aim: This study aimed to evaluate the impact of two different reperfusion techniques on outcomes of LT patients.

Background: Post-reperfusion syndrome (PRS) during liver transplantation (LT) remains a serious issue for both the surgeon and anesthetist.

Methods: In this prospective study, all liver transplant recipients referred to the liver transplantation department of Imam Khomeini Hospital, Tehran, Iran, from January 2016 to June 2017 were enrolled in the study and were divided into two groups of vented (reperfusion with 300cc blood venting) and non-vented (reperfusion without blood venting) cases. Then, 30-minute intraoperative hemodynamic and biochemical changes, as well as 2-month complications and 6-month mortality, were compared between the groups.

Results: 57 LT cases (31 vented and 26 non-vented) were studied (50.9% female). The two groups had a similar age (p = 0.107), sex (p = 0.885), MELD score (p = 0.61), donor warm ischemic time (p = 0.85), recipient warm ischemic time (p = 0.36), cold ischemic time (p = 0.99), comorbid disease (p = 0.502), and etiology of end-stage liver disease (p = 0.281). PRS occurred in 3 (11.5%) patients in the vented group and 4 (12.9%) in the non-vented group (p = 0.69). One (3.8%) patient in the non-vented group and 4 (12.9%) patients in vented group died (p = 0.229).

Conclusion: Reperfusion with and without blood venting had the same outcome regarding intraoperative hemodynamic and biochemical changes, PRS rate, and postoperative complications, as well as 6-month survival. Thus, it seems that blood venting is not a necessary method for decreasing post-reperfusion complications following LT.

Keywords: Liver transplantation; Mean arterial pressure; Reperfusion.

PubMed Disclaimer

Figures

Figure    1
Figure    1
Mean hemodynamic parameter changes before and 1, 5, 15, and 30 minutes post-reperfusion; Blue line = non-vented and green line = vented; SVR: systemic vascular resistance. Differences were not significant in the four comparisons (p > 0.05)
See this image and copyright information in PMC

References

    1. Starzl TE, Marchioro T, Von Kaulla K, Hermann G, Brittain R, Waddell W. Homotransplantation of the liver in humans. Surg Gynecol Obstet. 1963;117:659. - PMC - PubMed
    1. Starzl TE, Fung JJ. Themes of liver transplantation. Hepatology. 2010;51:1869–84. - PMC - PubMed
    1. Valentine E, Gregorits M, Gutsche JT, Al-Ghofaily L, Augoustides JG. Clinical update in liver transplantation. J Cardiothorac Vasc Anesth. 2013;27:809–15. - PubMed
    1. Reich DL, Wood Jr RK, Emre S, Bodian CA, Hossain S, Krol M, et al. Association of intraoperative hypotension and pulmonary hypertension with adverse outcomes after orthotopic liver transplantation. J Cardiothorac Vasc Anesth. 2003;17:699–702. - PubMed
    1. Aggarwal S. Postreperfusion syndrome: cardiovascular collapse following hepatic reperfusion during liver transplantation. Transplant Proc. 1987;19:54–5. - PubMed

LinkOut - more resources