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Utility of Basal Regional Oximetry as an Early Predictor of Graft Failure After Liver Transplant.

Abstract：

INTRODUCTION:Adequate perfusion and oxygenation to liver graft after transplantation is essential for its viability. Hepatic oximetry (hepatic tissue oxygenation [LSrO2]) through near infrared spectroscopy (NIRS) can help by showing real time oxygen content of the graft. METHODS:In this prospective study, we enrolled 50 consecutive patients undergoing liver transplant surgery from deceased donors. Liver NIRS (LSrO2) was continuously measured for 24 hours then analyzed and correlated with other clinical data such as hemoglobin (Hb), mixed venous oxygen saturation, cardiac index (CI), central venous pressure, arterial gases, diuresis, blood lactate, liver biochemistry, and normalized index ratio (INR). Severity disease scales and cold-warm ischemia time were also measured, as well as Doppler ultrasound (DUS) at hour 24. A statistical analysis with IBM SPSS 22 using Pearson correlation was carried out. RESULTS:LSrO2 could anticipate serious bleeding and hemodynamic events showing a decrease >10% from basal data. We found a significant correlation between LSrO2 with CI at 3 hours (P=.044), hemoglobin (Hb) at hour 3 and 24 (P = .004 and P = .002, respectively), and with Apache II (P=.041). A significant correlation was also detected between cold ischemia and INR at hour 24 (P=.016). No correlation of LSrO2 was found with lactate, liver biochemistry, and DUS data.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Pérez Civantos DV,Muñoz Cantero A,Robles Marcos M,Fuentes Morillas F,Cerezo Arias MO,Fariñas Seijas H

doi

10.1016/j.transproceed.2018.10.023

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

353-358

issue

2

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(18)31263-6

journal_volume

51

pub_type

杂志文章

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