Influência do propranolol pré‐operatório no índice cardíaco durante a fase anepática do transplante hepático

Abstract

IntroductionLiver transplantation (LT) is the best therapeutic option for end‐stage liver disease (ESLD). Non‐selective beta‐blocker medications such as propranolol act directly on the cardiovascular system (CVS) and are often used in the prevention of gastrointestinal bleeding resulting from HP. The effects of propranolol on CVS of cirrhotic patients during LT are not known. ObjectiveEvaluate the influence of propranolol used preoperatively on cardiac index (CI) during the anhepatic phase of LT. Method101 adult patients (73 male [72.2%]) who underwent cadaveric donor orthotopic liver transplantation by piggyback technique with preservation of the retrohepatic inferior vena cava performed at Hospital das Clinicas, Federal University of Minas Gerais were evaluated. There was no difference in severity between groups by the MELD system, p=0.70. The preoperative use of propranolol and the CI outcome were compared during the anhepatic phase of LT in 5 groups (I: increased CI, II: CI reduction lower than 16%, III: CI reduction equal to or greater than 16% and less than 31%, IV: CI reduction equal to or greater than 31% and less than 46%, V: CI reduction equal to or greater than 46%). ResultsPatients in group I (46.4%) who received propranolol preoperatively were statistically similar to groups II (60%), III (72.7%), IV (50%) and V (30.8%), p=0.57. ConclusionThe use of propranolol before transplantation as prophylaxis for gastrointestinal bleeding may be considered safe, as it was not associated with worsening of CI in anhepatic phase of LT.