Liver transplantation in the Intensive Care Unit: twenty years experience in a center medium income on Peru.
Rev Gastroenterol Peru
; 41(4): 227-232, 2021.
Article
in English
| MEDLINE | ID: covidwho-1863864
ABSTRACT
Liver transplantation is the major treatment for end-stage liver disease. Postoperative care is a great challenge to reduce morbidity and mortality in patients. In this sense, management in the liver ICU allows hemodynamic management, coagulation monitoring, renal support, electrolyte disturbances, respiratory support and early weaning from mechanical ventilation and evaluation of the liver graft. OBJECTIVE:
The present study shows the results of the management of liver transplant patients in 20 years of experience in a transplant center in a low- to middle-income country. MATERIALS ANDMETHODS:
The medical records of 273 adult patients in the ICU in the immediate postoperative liver transplant were reviewed, from March 20, 2000 to November 30, 2020, including the effect of the pandemic caused by COVID-19. Liver-kidney, retransplanted, SPLIT, and domino transplant patients were excluded.RESULTS:
The most frequent etiology for LTx was NASH (35%), the mean age was 49 years, MELD Score ranged 15 - 20 (47.5%), 21 - 30 (46%) > 30 (6.2%). ICU pre transplant stay 7%, average ICU stay 7.8 days. APACHE average admission 14.9 points. Weaning extubation of 91.8% patients in ICU and Fast Track in 8.2%. The most frequent respiratory complication was atelectasis 56.3%, pneumonia (31.3%); AKI 1 (60.9%), and 11.1% with hemodyalisis support (AKI3). Immunosuppression Tacrolimus (8.9%). Post-operative ICU mortality was 6.2%.CONCLUSIONS:
The management of liver transplantation in the ICU is essential to achieve optimal results in patients who present advanced liver disease and require advanced life support in the immediate postoperative period and thus optimize graft survival.
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Collection:
International databases
Database:
MEDLINE
Main subject:
Liver Transplantation
/
End Stage Liver Disease
/
COVID-19
Type of study:
Etiology study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Adult
/
Humans
/
Middle aged
Country/Region as subject:
South America
/
Peru
Language:
English
Journal:
Rev Gastroenterol Peru
Journal subject:
Gastroenterology
Year:
2021
Document Type:
Article
Affiliation country:
Peru
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