Analysis of 83 consecutive liver transplants performed at a tertiary care reference hospital in the interior of the state of Sao Paulo

Abstract

PURPOSE:To analyze pre-, intra-and immediate postoperative parameters of patients submitted to liver transplantation. METHODS: Eighty-three consecutive orthotopic liver transplants performed from January 2009 to July 2011 were analyzed. The patients were divided into 2 groups: A, survivors (MELD between 9 and 60) and B, non-survivors (MELD between 14 and 40), with 30.6% of group A patients being CHILD C, 51℅ CHILD B and 18,4℅ CHILD A. In group B ,32.1℅ of the patients were CHILD C, 42,9℅ CHILD B, and 25℅ CHILD A. All orthotopic liver transplantations were performed using the piggyback technique without a portacaval shunt. Systemic arterial pressure and serum ALT and AST levels were determined preoperatively and 5, 60 and 1440 minutes after arterial graft revascularization. Serum ALT and AST profiles were evaluated for seven days after surgery. RESULTS: Systemic arterial blood pressure levels, time of hot and hypothermic ischemia and time of graft implant were statistically similar for the two groups (p>0.05). Serum levels (U/L) of ALT and AST at the 5, 60 and 1440 minute time points after arterial revascularization of the graft were also similar for the two groups studied, as also were the serum ALT and AST profiles. CONCLUSIONS: No statistically significant difference in any of the parameters studied was detected between the two groups. Under the conditions of the present study and on the basis of the parameters evaluated, no direct relation was detected between the intraoperative period and the type of patient outcome in the two groups studied. Keywords: Liver Transplantation. Transaminases. Blood Pressure. Todos os transplantes ortotópicos de fígado foram feitos com a técnica de piggyback sem "shunt" porto cava. Foram analisados os valores de pressão arterial sistêmica e os níveis séricos de ALT e AST, no pré-operatório, 5, 60 e 1440 minutos após revascularização arterial do enxerto. Avaliaram-se os perfis séricos da ALT e AST durante sete dias de pós-operatorio. RESULTADOS: Verificou-se que em ambos os grupos, os níveis de pressão arterial sistêmica, os tempos de isquemia normotérmica, hipotérmica e de implante do enxerto foram estatisticamente semelhantes (p>0,05). Os níveis séricos (U/L) de ALT e AST nos tempos de 5, 60 e 1440 minutos após a revascularização arterial do enxerto também foram semelhantes nos grupos estudados. Os perfis séricos da ALT e AST foram semelhantes nos dois grupos estudados. CONCLUSÕES: Não se verificou diferença estatisticamente significante entre todos os parâmetros estudados, em ambos os grupos. Nas condições do presente estudo, não se verificou relação direta do intra-operatório com o tipo de evolução (outcome) dos pacientes nos dois grupos estudados. Descritores: Transplante de Fígado. Transaminases. Pressão Arterial. Analysis of 83 consecutive liver transplants performed at a tertiary care reference hospital in the interior of the State of Sao PauloActa Cirúrgica Brasileira -Vol. 26 (6) 2011 -531

The Impact of the Meld Score on Liver Transplant Allocation and Results: An Integrative Review

“…In terms of age and the predominance of male transplant patients, the findings of the various studies were similar 3 , 9 , 14 , 15 . Waiting-list mortality and exclusion for reason of worsening of the underlying condition are more common among women, possibly because of lower creatinine levels.…”

“…The Ministry of Health defines cases of hepatitis C confirmed by positive anti-HCV and HCV-RNA as detectable. The detection rate is high and more common in patients aged between 30 and 59 years and has been reported by Sharpton et al 24 as the main indication for transplantation in young patients 14 .…”

Prospective analysis of 44 consecutive liver transplants performed at a university hospital

“…No significant difference was observed between groups during the first 24 and 48 hours after surgery (p>0.05), Tables 2 and 3. The aminotransferases ALT and AST and LDH 4 , sensitive markers of acute hepatocellular injury, have proved to be sensitive in indicating different levels of (I/R injury, although they do not demonstrate significant differences in the type of outcome of transplanted patients 14 . In the present investigation, no statistically significant difference was detected in the levels of these enzymes between the two types of outcome studied.…”