Association of different central venous pressure levels with outcome of living-donor liver transplantation in children under 12 years

Fan, Yichen; Wang, Xiaoqiang; Zhu, Danyan; Huai, Xiaorong; Yu, Weifeng; Su, Diansan; Pan, Zhiying

doi:10.1007/s12519-022-00632-3

Cited by 3 publications

(2 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The central venous catheter (CVC) is a standard of care for liver transplantation [1 ▪▪ ,29,105]. A recent review of literature showed that low central venous pressure (LCVP) decreases surgical bleeding and improves postoperative outcomes in hepatectomies including in pediatrics [10,56]. The threshold for LCVP is traditionally less than 5 mmHg; however, a recent study showed that a LCVP of less than 8 mmHg is equally beneficial and more practical to reach and correlates with a stroke volume variation (SVV) more than 13% [55].…”

Section: Central Venous Cathetermentioning

confidence: 99%

Hemodynamic monitoring in liver transplantation ‘the hemodynamic system’

Kandil,

Sedra

2023

Current Opinion in Organ Transplantation

View full text Add to dashboard Cite

Purpose of review The purpose of this article is to provide a comprehensive review of hemodynamic monitoring in liver transplantation. Recent findings Radial arterial blood pressure monitoring underestimates the aortic root arterial blood pressure and causes excessive vasopressor and worse outcomes. Brachial and femoral artery monitoring is well tolerated and should be considered in critically ill patients expected to be on high dose pressors. The pulmonary artery catheter is the gold standard of hemodynamic monitoring and is still widely used in liver transplantation; however, it is a highly invasive monitor with potential for serious complications and most of its data can be obtained by other less invasive monitors. Rescue transesophageal echocardiography relies on few simple views and should be available as a standby to manage sudden hemodynamic instability. Risk of esophageal bleeding from transesophageal echocardiography in liver transplantation is the same as in other patient populations. The arterial pulse waveform analysis based cardiac output devices are minimally invasive and have the advantage of real-time beat to beat monitoring of cardiac output. No hemodynamic monitor can improve clinical outcomes unless integrated into a goal-directed hemodynamic therapy. The hemodynamic monitoring technique should be tailored to the patient's medical status, surgical technique, and the anesthesiologist's level of expertise. Summary The current article provides a review of the current hemodynamic monitoring systems and their integration in goal-directed hemodynamic therapy.

show abstract

Section: Central Venous Cathetermentioning

confidence: 99%

Hemodynamic monitoring in liver transplantation ‘the hemodynamic system’

Kandil,

Sedra

2023

Current Opinion in Organ Transplantation

View full text Add to dashboard Cite

show abstract

“…Pediatric liver transplantation is an important modality for treating biliary atresia. Living-donor liver transplantation has been widely performed to solve the problem of donor shortage ( 1 ). The overall survival rate of pediatric liver transplantation has significantly improved, while 1-year all-cause mortality is 4.78%, remaining unsatisfactory ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

A 7-month-old girl with a suspected air embolism complication during a living-donor liver transplantation procedure: a case report

Huang,

Yang,

et al. 2023

Front. Pediatr.

View full text Add to dashboard Cite

BackgroundPediatric liver transplantation is an important modality for treating biliary atresia. The overall survival rate of pediatric liver transplantation has significantly improved. The incidence of perioperative cardiac events was evaluated, and risk factors were also investigated in adult patients undergoing liver transplantation in previous studies. To the best of our knowledge, this is the first case of a cardiac event during a pediatric living-donor liver transplantation.Case summaryOur report describes the management of cardiac events during a liver transplantation in a 7-month-old girl. The ST segment began to increase to 3.0 mm immediately after reperfusion, with peak ST-segment elevation reaching 13.2 mm after 45 min. The procedure ended uneventfully after continuous symptomatic and etiological treatment. It was considered to be the occurrence of an acute air embolism complication during the procedure based on the electrocardiograph and biomarkers. An echocardiogram during follow-up showed a patent foramen ovale with a left-to-right shunt tract width of 2.7 mm.DiscussionPediatric liver transplantation has become a state-of-the-art treatment for children with end-stage liver disease and can improve the quality of life to some extent. These children may be complicated with congenital heart disease, which increases the risk of surgery. Application of echocardiogram, close monitoring, and appropriate management may reduce the incidence of perioperative cardiac events.

show abstract

Development and validation of a nomogram to predict allograft survival after pediatric liver transplantation

Gu,

Pan,

Fan

et al. 2023

World J Pediatr

View full text Add to dashboard Cite

Background Liver transplantation is the main treatment for cholestatic liver disease and some metabolic liver diseases in children. However, no accurate prediction model to determine the survival probability of grafts prior to surgery exists. This study aimed to develop an effective prognostic model for allograft survival after pediatric liver transplantation. Methods This retrospective cohort study included 2032 patients who underwent pediatric liver transplantation between January 1, 2006, and January 1, 2020. A nomogram was developed using Cox regression and validated based on bootstrap sampling. Predictive and discriminatory accuracies were determined using the concordance index and visualized using calibration curves; net benefits were calculated for model comparison. An online Shiny application was developed for easy access to the model. Results Multivariable analysis demonstrated that preoperative diagnosis, recipient age, body weight, graft type, preoperative total bilirubin, interleukin-1β, portal venous blood flow direction, spleen thickness, and the presence of heart disease and cholangitis were independent factors for survival, all of which were selected in the nomogram. Calibration of the nomogram indicated that the 1-, 3-, and 5-year predicted survival rates agreed with the actual survival rate. The concordance indices for graft survival at 1, 3, and 5 years were 0.776, 0.757, and 0.753, respectively, which were significantly higher than those of the Pediatric End-Stage Liver Disease and Child–Pugh scoring systems. The allograft dysfunction risk of a recipient could be easily predicted using the following URL: https://aspelt.shinyapps.io/ASPELT// Conclusion The allograft survival after pediatric liver transplantation (ASPELT) score model can effectively predict the graft survival rate after liver transplantation in children, providing a simple and convenient evaluation method for clinicians and patients.

show abstract

Association of different central venous pressure levels with outcome of living-donor liver transplantation in children under 12 years

Cited by 3 publications

References 32 publications

Hemodynamic monitoring in liver transplantation ‘the hemodynamic system’

Hemodynamic monitoring in liver transplantation ‘the hemodynamic system’

A 7-month-old girl with a suspected air embolism complication during a living-donor liver transplantation procedure: a case report

Development and validation of a nomogram to predict allograft survival after pediatric liver transplantation

Contact Info

Product

Resources

About