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Intraoperative Management and Postoperative Outcome in Intestine-Inclusive Liver Transplantation Versus Liver
X Song1, D G Farmer2, V W Xia3
1Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University of School of Medicine.
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.
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