The anhepatic phase extended by temporary portocaval shunt does not affect anesthetic sensitivity and postoperative...

Area of Science:

• Anesthesiology
• Hepatology
• Transplant Surgery

Background:

• Temporary portocaval shunt (TPCS) extends the anhepatic phase in living donor liver transplantation (LDLT).
• The anhepatic phase is associated with the highest anesthetic sensitivity.
• Cognitive dysfunction links to anesthetic sensitivity and poor liver function.

Purpose of the Study:

• To assess desflurane anesthetic sensitivity and cognitive function in LDLT patients with TPCS.
• To test if a prolonged anhepatic phase increases anesthetic sensitivity and causes cognitive decline.

Main Methods:

• A case-control study of 67 LDLT patients.
• Anesthesia maintained at 0.6 age-adjusted MAC desflurane.
• Bispectral Index (BIS) and Mini-Mental State Examination (MMSE-KC) monitored pre- and post-operation.

Main Results:

• TPCS (n=16) significantly prolonged the anhepatic phase (125.9 vs 54.9 minutes).
• Averaged BIS values and MMSE-KC scores showed no significant differences between TPCS and non-TPCS groups.
• No significant interval changes in BIS or MMSE-KC scores were observed postoperatively.

Conclusions:

• Prolonging the anhepatic phase with TPCS did not impact anesthetic sensitivity.
• TPCS did not lead to postoperative cognitive decline in LDLT patients.