Impact of core hypothermia during reperfusion on acute pulmonary edema after liver transplantation in patients with chronic severe hepatitis / 中华普通外科杂志

ABSTRACT

Objective To investigate the influence of hypothermia during reperfusion on acute pulmonary edema(APE)after liver transplantation in patients with chronic severe hepatitis. Methods Between February 2002 and December 2006,108 consecutive patients of chronic severe hepatitis underwent liver transplantation. Patients suffering from postoperative APE(APE group)were compared with those without APE(NAPE group)on hypothermia during reperfusion. We evaluated the impact of hypothermia on requirement of red blood cells and/or fresh-frozen plasma, and prothrombin time in neo-liver phase. Results Forty-one out of these 108(37.96%)cases were complicated with APE. Compared with NAPE group, patients in APE group have significant lower core hypothermia(t=2.413,P=0.018),longer hypothermia duration(＞5 min)(39.02%,x2=143.40).Longer pmthrombin time(t=2.884,P=0.005)and larger amount of blood transfnsion were observed in APE group. Patients with hypothermia were prone to accompanied with longer PT in neo-liver phase(28.03±8.45)min vs (24.12±5.89)min, t=2.553,P=0.012),larger requiting of RBC transfusion(2786.96±1266.47)ml vs(2129.41±805.90) ml, t=2.364,P=0.026)and fresh-frozen plasma(2121.74±676.19)ml vs (1768.24±685.08) ml, t=2.201,P=0.030).Conclusions Low core hypothermia during neo-liver reperfusion contributes to the development of APE in patients with chronic severe hepatitis undergoing liver transplantation. Prolonged PT and large amount of blood transfusion may be involved in this complication.