Abstract
To analyze pre-, intra- and immediate postoperative parameters of patients submitted to liver transplantation. Eighty-three consecutive orthotopic liver transplants performed from January 2009 to July 2011 were analyzed. The patients were divided into 2 groups: A, survivors (MELD between 9 and 60) and B, non-survivors (MELD between 14 and 40), with 30.6% of group A patients being CHILD C, 51℅ CHILD B and 18,4℅ CHILD A. In group B, 32.1℅ of the patients were CHILD C, 42,9℅ CHILD B, and 25℅ CHILD A. All orthotopic liver transplantations were performed using the piggyback technique without a portacaval shunt. Systemic arterial pressure and serum ALT and AST levels were determined preoperatively and 5, 60 and 1440 minutes after arterial graft revascularization. Serum ALT and AST profiles were evaluated for seven days after surgery. Systemic arterial blood pressure levels, time of hot and hypothermic ischemia and time of graft implant were statistically similar for the two groups (p>0.05). Serum levels (U/L) of ALT and AST at the 5, 60 and 1440 minute time points after arterial revascularization of the graft were also similar for the two groups studied, as also were the serum ALT and AST profiles. No statistically significant difference in any of the parameters studied was detected between the two groups. Under the conditions of the present study and on the basis of the parameters evaluated, no direct relation was detected between the intraoperative period and the type of patient outcome in the two groups studied.
Highlights
Patients with cirrhosis of the liver course with a hyperdynamic systemic circulation, manifested by an increased cardiac output and decreased peripheral vascular resistance and arterial pressure[1]
Under the conditions of the present study and on the basis of the parameters evaluated, no direct relation was detected between the intraoperative period and the type of patient outcome in the two groups studied
The patients were divided into 2 groups: A, survivors (MELD between 9 and 60), and B, nonsurvivors, (MELD between 14 and 40), with 30.6c/o of group A patients being CHILD C, 51.0c/o CHILD B and 18.4c/o CHILD A
Summary
Patients with cirrhosis of the liver course with a hyperdynamic systemic circulation, manifested by an increased cardiac output and decreased peripheral vascular resistance and arterial pressure[1]. These changes intensify with disease progression and are reversible with liver transplantation. This surgical procedure is highly complex for the treatment of preventable diseases such as cirrhosis due to complications of hepatitis B virus and hepatitis C virus and alcohol-induced cirrhosis in 80% of cases[2]. Patients submitted to a liver transplant have post-transplant 5-year survival rates ranging from 70 to 90%3-5
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