ABSTRACT
The so-called learning factor has been disregarded for many years in analyzing the causes of surgical complications and post-operative mortality; it is also the case for OLT. In our center until April 2003, 209 OLT were performed in 196 patients. We evaluated the impact of experience of the transplantation team on the outcomes of liver transplantation. Thirty-four patients died (mortality rate, 16%) and 1-year survival rate, 64%. Mortality rates varied during different periods of observation due to increasing experience of the transplantation team. The causes of mortality were assessed for a series of 34 patients: it was 75% at the beginning of transplantation procedures while recent deaths have not recently exceeded 10% of cases.
Subject(s)
Liver Transplantation/statistics & numerical data , Gallbladder Diseases/epidemiology , Humans , Liver Transplantation/mortality , Postoperative Complications/classification , Postoperative Complications/epidemiology , Retrospective Studies , Survival Rate , Treatment OutcomeABSTRACT
The majority of liver transplanted patients are severely malnourished that increases the incidence of postoperative morbidity and mortality. The authors analysed the effects of nutritional support-total parenteral nutrition-in 11 adult orthotopic liver allograft recipients (9 women, 2 men) transplanted for chronic or acute liver failure in 1994-1997. 4.3-9.75 g of N/24h, 1200-1700 kcal in 1750-2750 ml, from 2-5th postoperative day was administered via central vein in all-in-one system for 4-46 days. Neither metabolic nor septic complications related to the nutrition were observed. The function of the transplanted liver was not impaired by the nutrition. One patient died in course of hepatic coma, 10 patients are alive and in good general condition (1-29 months). In conclusion, the total parenteral nutrition is safe, beneficial and thus recommended routine therapy in the treatment of the liver transplanted malnourished patients.
Subject(s)
Liver Transplantation/rehabilitation , Nutrition Disorders/therapy , Parenteral Nutrition, Total , Adult , Female , Humans , Liver Failure/complications , Liver Failure/surgery , Male , Middle Aged , Nutrition Disorders/etiology , Treatment OutcomeSubject(s)
Enteral Nutrition , Evaluation Studies as Topic , Female , Food, Formulated , Humans , Male , Nutritional Requirements , Nutritive Value , Postoperative CareABSTRACT
In surgical septic patients a significant decrease of the red cell ATP concentration was observed in last two days before death. Only in renal failure (with high Pi serum level) this phenomenon was not observed. In malnourished patients with very low red cell ATP, administration of a high Pi dose resulted in some elevation of the ATP.