Intra-operative cardiac arrests during liver transplantation - a retrospective review of the first 15 yr in Asian population.

Abstract:

:Although many report intra-operative cardiac arrests (ICAs) in liver transplantation (LT), the incidence, major causes, and outcome remain unclear. We aimed to investigate retrospectively, the incidence, nature, and outcome of ICA in Asian population and to identify risk factors for ICA. Consecutive 1071 LTs in an institution during 1996-2011 (adult 920, pediatric 151/living donor liver transplantation, LDLT 841, deceased donor liver transplantation, DDLT 230) were reviewed. ICA occurred in 14 adult LTs (1.5%), but none in pediatrics. ICA occurred 1.0% and 3.3% in LDLT and DDLT, respectively. Stages of ICA incidence were three at pre-anhepatic, one at anhepatic, and 10 at neohepatic stage. Post-reperfusion syndrome (PRS) with hyperkalemia and bleeding were the major causes of ICA. While LDLT showed miscellaneous causes for ICA at various stages, DDLT incurred ICAs at neohepatic stage only. Interestingly, we did not find pulmonary thromboembolism (PTE) to incur ICA. Risk factor analysis showed no association of pre-operative patient condition, donor types, and intra-operative parameters. In this review, the incidence of ICA was low in Asian population with LDLT predominance, and while PTE was not the cause of ICA, the neohepatic stage with PRS and bleeding was the most vulnerable period to anticipate ICA.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Lee SH,Gwak MS,Choi SJ,Shin YH,Ko JS,Kim GS,Lee SY,Kim MH,Park HG,Lee SK,Jeon HJ

doi

10.1111/ctr.12085

subject

Has Abstract

pub_date

2013-03-01 00:00:00

pages

E126-36

issue

2

eissn

0902-0063

issn

1399-0012

journal_volume

27

pub_type

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