Changes in core temperature during graft warm ischemia and reperfusion phases during living donor liver transplant: Adult versus pediatric

Abstract

Background: Maintaining normothermia is essential during liver transplant. Serious adverse outcomes from perioperative hypothermia are well documented. Objective: To evaluate the core temperature changes during graft warm ischemia and reperfusion periods in adult and pediatric cases. Method: 30 recipients,(adult n=15 and pediatric n=15) were enrolled in this study. Nasopharyngeal core temperature (NC'I) was recorded at the following points: 5 and 30 minutes after induction of anesthesia (tempi&2), the lowest NCT during dissection phase (temp3), the lowest NCT during the anhepatic phase and before implantation of the graft (temp4), lowest NCT during warm ischemia (putting the graft at its bed till reperfusion) (temp5), also at 5 (temp6) and 30 minutes (temp7) after reperfusion, then before the end of surgery (temp8). Results: Significant decrease in core temperature during the anhepatic phase (temp4), warm ischemia time (temp5), 5 minutes after reperfusion (temp6) and 30 minutes after reperfusion (temp7) with mean values of 36.4 ± 0.47°C, 35.4±0.45°C, 35.2±0.50°C and 35.2±0.52°C respectively in the pediatric group, while in adult group the mean values36.3±0.330C, 36.1±0.380C, 36.1±0.6JOC and 35.9±0.34°C respectively. Conclusion: Significant drop in NCT was observed at the beginning of the warm ischemia period that persisted through the reperfusion phase in both adult and pediatric recipients. Children with a body weight <14 kg had their core temperatures affected more than adult patients because of receiving relatively large grafts with a greater GRWR.