Atrial fibrillation during anhepatic phase liver transplantation: Now what?

Prakash, Kelika; Karna, Sunaina Tejpal; Pandey, Chandra Kant

doi:10.4103/joacp.joacp_234_17

Cited by 2 publications

(2 citation statements)

References 5 publications

(5 reference statements)

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“…[52][53][54] The estimated incidence of atrial fibrillation (AF) in patients with ESLD is about 8.5% 55 and may be related to chronic inflammation. 39,56 An association between AF and intraoperative HDI has been discussed only in case reports, 57,58 but an association between AF and increased posttransplant mortality has been demonstrated. 55,59 Postreperfusion Syndrome PRS is defined as a decrease in mean arterial pressure (MAP) >30% below baseline that lasts for at least 1 min occurring within 5 min after graft reperfusion.…”

Section: Arrhythmiasmentioning

confidence: 99%

“…52-54 The estimated incidence of atrial fibrillation (AF) in patients with ESLD is about 8.5% 55 and may be related to chronic inflammation. 39,56 An association between AF and intraoperative HDI has been discussed only in case reports, 57,58 but an association between AF and increased posttransplant mortality has been demonstrated. 55,59…”

Section: Hemodynamic Instability During Liver Transplantationmentioning

confidence: 99%

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Hemodynamic Instability During Liver Transplantation in Patients With End-stage Liver Disease: A Consensus Document from ILTS, LICAGE, and SATA

et al. 2021

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Hemodynamic instability (HDI) during liver transplantation (LT) can be difficult to manage and increases postoperative morbidity and mortality. In addition to surgical causes of HDI, patient-and graft-related factors are also important. Nitric oxide-mediated vasodilatation is a common denominator associated with end-stage liver disease related to HDI. Despite intense investigation, optimal management strategies remain elusive.In this consensus article, experts from the International Liver Transplantation Society, the Liver Intensive Care Group of Europe, and the Society for the Advancement of Transplant Anesthesia performed a rigorous review of the most current literature regarding the epidemiology, causes, and management of HDI during LT. Special attention has been paid to unique LT-associated conditions including the causes and management of vasoplegic syndrome, cardiomyopathies, LT-related arrhythmias, right and left ventricular dysfunction, and the specifics of medical and fluid management in end-stage liver disease as well as problems specifically related to portal circulation. When possible, management recommendations are made.

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Section: Arrhythmiasmentioning

confidence: 99%

Section: Hemodynamic Instability During Liver Transplantationmentioning

confidence: 99%

Hemodynamic Instability During Liver Transplantation in Patients With End-stage Liver Disease: A Consensus Document from ILTS, LICAGE, and SATA

et al. 2021

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New onset atrial fibrillation during orthotopic liver transplantation induced by iced saline injection for transpulmonary thermodilution: a case report

Wang

Guo

2022

J Int Med Res

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Transpulmonary thermodilution is often used to measure extravascular lung water during liver transplantation. Here, the case of new onset atrial fibrillation during orthotopic liver transplantation, which may have been induced by iced saline injection for transpulmonary thermodilution measurement, is described. A 52-year-old male patient underwent orthotopic liver transplantation due to alcoholic cirrhosis combined with portal hypertension. During dissection of the recipient liver, transpulmonary thermodilution was performed. At 3 minutes following iced saline injected, atrial fibrillation occurred, the ventricular rate increased to more than 120 beats per min, and blood pressure dropped to 75/50 mmHg. Massive haemorrhage, inferior vena cava clamping, electrolyte disorder, acid-base balance disorder, and hypothermia were all ruled out, and iced saline injection was suspended. Hemodynamic stability was maintained with phenylephrine and lanatocide C (cedilanid), and chemical cardioversion was performed using amiodarone. During the reperfusion phase, transient hemodynamic instability was managed by norepinephrine. The neohepatic phase was uneventful. Atrial fibrillation lasted for 5 days and reversed to sinus rhythm automatically. The patient was hemodynamically stable during this period, and recovery was smooth with no thromboembolic events. In conclusion, atrial fibrillation may be induced by iced saline injection for transpulmonary thermodilution measurement during orthotopic liver transplantation.

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Atrial fibrillation during anhepatic phase liver transplantation: Now what?

Cited by 2 publications

References 5 publications

Hemodynamic Instability During Liver Transplantation in Patients With End-stage Liver Disease: A Consensus Document from ILTS, LICAGE, and SATA

Hemodynamic Instability During Liver Transplantation in Patients With End-stage Liver Disease: A Consensus Document from ILTS, LICAGE, and SATA

New onset atrial fibrillation during orthotopic liver transplantation induced by iced saline injection for transpulmonary thermodilution: a case report

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