The program of liver transplantation in Republic of Belarus. Influence of liver orthotopic tranplantation technical aspects on early postoperative complications
AbstractObjectives. The aim of the study was to evaluate influence of different liver transplantation techniques on incidence postoperative complications. Material and methods. Retrospective case-control study of 166 patients with end-stage liver disease was performed. All patients were divided in two groups: the first one – 141 cases of classic liver transplantation technique without inferior vena cava (IVC) preservation and the second – 25 cases with IVC preservation technique (cavaplasty, piggy-back). Initial portal vein reperfusion (IPR) was performed in 118 cases, simultaneous reperfusion (SIMR) – in 48 cases. Both groups were compatible due to diagnosis, MELD score, DRI, total ischemia time. Results. Mean total ischemia time was 475±123 min (454±134 min in case of IPR and 492±118 min in case of SIMR, p>0,05). Ahepatic period was longer in case of SIMR than IPR (78 min vs. 58 min, p=0,002). Among all patients acute kid- ney injury developed in 33 (19,9%) cases, early allograft dysfunction – in 46 (27,7%) cases, ITBL – in 5 (3,4%) cases. Conclusion. In case of mean total ischemia time of 8 h, liver transplantation technique and type of reperfusion do not influence on incidence of early postoperative complications. Postoperative renal function depends on patient’s comorbidity status, presence of preoperative renal failure and development of early allograft dysfunction, blood loss on transplantation.
Keywords:liver transplantation, brain dead donor, acute kidney injury, cavaplasty, early allograft dysfunction, ischemic biliary stricture
Clin. Experiment. Surg. Petrovsky J. – 2014. – N 2. – P. 5–10.