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Postreperfusion syndrome during liver transplantation / 대한마취과학회지
Korean Journal of Anesthesiology ; : 527-539, 2015.
Artículo en Inglés | WPRIM | ID: wpr-153544
ABSTRACT
As surgical and graft preservation techniques have improved and immunosuppressive drugs have advanced, liver transplantation (LT) is now considered the gold standard for treating patients with end-stage liver disease worldwide. However, despite the improved survival following LT, severe hemodynamic disturbances during LT remain a serious issue for the anesthesiologist. The greatest hemodynamic disturbance is postreperfusion syndrome (PRS), which occurs at reperfusion of the donated liver after unclamping of the portal vein. PRS is characterized by marked decreases in mean arterial pressure and systemic vascular resistance, and moderate increases in pulmonary arterial pressure and central venous pressure. The underlying pathophysiological mechanisms of PRS are complex. Moreover, risk factors associated with PRS are not fully understood. Rapid and appropriate treatment with vasopressors, volume replacement, or venesection must be provided depending on the cause of the hemodynamic disturbance when hemodynamic instability becomes profound after reperfusion. The negative effects of PRS on postoperative early morbidity and mortality are clear, but the effect of PRS on postoperative long-term mortality remains a matter of debate.
Asunto(s)

Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Vena Porta / Resistencia Vascular / Reperfusión / Presión Venosa Central / Factores de Riesgo / Mortalidad / Trasplante de Hígado / Flebotomía / Trasplantes / Presión Arterial Tipo de estudio: Estudio de etiología / Estudio pronóstico / Factores de riesgo Límite: Humanos Idioma: Inglés Revista: Korean Journal of Anesthesiology Año: 2015 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Vena Porta / Resistencia Vascular / Reperfusión / Presión Venosa Central / Factores de Riesgo / Mortalidad / Trasplante de Hígado / Flebotomía / Trasplantes / Presión Arterial Tipo de estudio: Estudio de etiología / Estudio pronóstico / Factores de riesgo Límite: Humanos Idioma: Inglés Revista: Korean Journal of Anesthesiology Año: 2015 Tipo del documento: Artículo