Haemodynamics of liver reperfusion: comparison of two anaesthetic techniques

Reperfusion during liver transplantation is associated with cardiovascular instability. We have compared the effects of two anaesthetic techniques on these changes. Twenty-six consecutive patients undergoing elective orthotopic liver transplantation were anaesthetized using either isoflurane or propofol. Haemodynamic profiles were studied before and at specific times after liver graft reperfusion. Systemic vascular resistance decreased at reperfusion in both groups (P < 0.0001), which was accompanied by increased cardiac output which attenuated changes in mean arterial pressure. In the isoflurane group, cardiac output was maintained primarily by improvement in stroke volume, whereas in the propofol group the increase in stroke volume was less marked and cardiac output was maintained by a greater heart rate. The cardiovascular changes were tolerated less well in those patients receiving propofol.