Intraoperative management of liver transplant recipients having severe renal dysfunction: results of 42 cases
Annals of Surgical Treatment and Research
;
: 45-53, 2018.
Article
in English
| WPRIM
| ID: wpr-715668
ABSTRACT
PURPOSE:
Whereas continuous renal replacement therapy (CRRT) has been utilized during liver transplantation (LT), there was a lack of evidence to support this practice. We investigated the adverse events at the perioperative periods in recipients of LT who received preoperative CRRT without intraoperative CRRT.METHODS:
We retrospectively reviewed medical records of adult patients (age ≥ 18 years) who received LT between December 2009 and May 2015. Perioperative data were collected from the recipients, who received preoperative CRRT until immediately before LT, because of refractory renal dysfunction.RESULTS:
Of 706 recipients, 42 recipients received preoperative CRRT. The mean (standard deviation) Model for end-stage liver disease score were 49.6 (13.4). Twenty-six point two percent (26.2%) of recipients experienced the serum potassium > 4.5 mEq/L before reperfusion and treated with regular insulin. Thirty-eight point one percent (38.1%) of recipients were managed with sodium bicarbonate because of acidosis (base excess 5.5 mEq/L), refractory acidosis, or critical arrhythmias. Mortality was 19% at 30 day and 33.3% at 1 year.CONCLUSION:
Although intraoperative CRRT was not used in recipients with severe preoperative renal dysfunction, LT was safely performed. Our experience raises a question about the need for intraoperative CRRT.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Arrhythmias, Cardiac
/
Potassium
/
Acidosis
/
Reperfusion
/
Medical Records
/
Retrospective Studies
/
Mortality
/
Liver Transplantation
/
Sodium Bicarbonate
/
Renal Replacement Therapy
Type of study:
Observational study
/
Prognostic study
Limits:
Adult
/
Humans
Language:
English
Journal:
Annals of Surgical Treatment and Research
Year:
2018
Type:
Article
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