Enhanced recovery after surgery programs improve short‐term outcomes after liver transplantation–A systematic review and meta‐analysis

Tinguely, Pascale; Morare, Nolitha; Val, Alejandro Ramírez-Del; Berenguer, Marina; Niemann, Claus U.; Pollok, Joerg M.; Raptis, Dimitri Aristotle; Spiro, Michael

doi:10.1111/ctr.14453

Cited by 29 publications

(22 citation statements)

References 40 publications

(113 reference statements)

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“…They concluded that ERAS protocols in LT are related to improved short-term outcomes after LT with moderate to low quality of evidence and strong grade of recommendation. 63…”

Section: Liver Transplantation (Table 2)mentioning

confidence: 99%

“…DHOPE-DCD Trial -HOPE to prevent biliary complication post-LT: van Rijn, et al 58 HOPE (n = 78) led to a lower risk of nonanastomotic biliary strictures following LT with livers obtained from donors after circulatory death vs those from conventional static cold storage (n = 78) (6% vs 18%; RR .36). ERAS for LT: Tinguely, et al 63 ERAS protocols in LT led to decreased overall complications (OR .4) and decreased ICU and hospital length of stays. ERAS after LT is recommended (moderate to low quality of evidence; strong grade of recommendation).…”

Section: Liver Transplantationmentioning

confidence: 99%

“…Tinguely and colleagues performed a systematic review and meta-analysis to determine whether ERAS improved early outcomes after LT when applying comprehensive ERAS protocols (> 1 ERAS component) vs standard routine care groups. 63 They identified 2 randomized controlled trials, 2 prospective studies, and 1 retrospective cohort study performed between 2002 to 2020. Frequent ERAS components were early extubation and postoperative antibiotic, fluid, and nutrition management, but the application of ERAS components was not standardized.…”

Section: Erasmentioning

confidence: 99%

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Abdominal Organ Transplantation: Noteworthy Literature in 2021

Jules

Blech

Sakai

2022

Semin Cardiothorac Vasc Anesth

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This review highlights noteworthy literature pertinent to anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. In 2021, we identified noteworthy papers from over 1,200 peer-reviewed publications on pancreatic transplantation, over 1,400 on intestinal transplantation, and over 9,000 on kidney transplantation. The liver transplantation section focuses on clinical trials and systematic reviews and meta-analyses published in 2021 and features 20 selected papers. COVID-19 and abdominal organ transplantation are featured in an independent section.

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“…They concluded that ERAS protocols in LT are related to improved short-term outcomes after LT with moderate to low quality of evidence and strong grade of recommendation. 63…”

Section: Liver Transplantation (Table 2)mentioning

confidence: 99%

Section: Liver Transplantationmentioning

confidence: 99%

Section: Erasmentioning

confidence: 99%

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Abdominal Organ Transplantation: Noteworthy Literature in 2021

Jules

Blech

Sakai

2022

Semin Cardiothorac Vasc Anesth

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“…Only 7 of 391 patients (1.8%) required re-intubation. A recent systematic review investigated the quality of evidence for early extubation after LT as a part of an enhanced recovery after surgery (ERAS) project performed by the International Liver Transplantation Society (ILTS) [ 35 ]. They found that, overall, complications were reduced in the ERAS cohort versus controls (OR = 0.4 (CI 0.2, 0.7)), with no significant differences in mortality or hospital readmission rates.…”

Section: Mechanical Ventilation After Transplantationmentioning

confidence: 99%

The Edge of Unknown: Postoperative Critical Care in Liver Transplantation

Saner

Hoyer

Hartmann

et al. 2022

JCM

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Perioperative care of patients undergoing liver transplantation (LT) is very complex. Metabolic derangements, hypothermia, coagulopathy and thromboses, severe infections, and graft dysfunction can affect outcomes. In this manuscript, we discuss several perioperative problems that can be encountered in LT recipients. The authors present the most up-to-date information regarding predicting and treating hemodynamic instability, coagulation monitoring and management, postoperative ventilation strategies and early extubation, management of infections, and ESLD-related pulmonary complications. In addition, early post-transplant allograft dysfunction will be discussed.

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“…Many factors can be classified as risk factors, include gender, APACHE score, average medical research council score, number of days of ICU stay and number of days of mechanical ventilation [6][7][8]. Early intervention of physical therapy and ERAS is highly recommended to avoid limitation in ADL activities and future disability [9][10][11][12][13][14][15]. However, no literature proves that on short-term ICU admission, especially those who underwent many procedures and was in ICU many times within short period in-between admissions.…”

Section: Introductionmentioning

confidence: 99%

A Case of Short- Term Intensive Care Unit-Acquired Weakness Post-Renal Graft Nephrectomy after Liver and Kidney Transplant

Al-Issa¹

2022

J PhyMed Rehab Stud Rep

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Background: In this study, we shed the light on the effect of two short-term ICU admissions within short period in-between admissions and the undesirable results in core muscles, lower limb motor power and physical abilities. We emphasized the importance of early intervention of physical therapy during ICU admission and after. Case Report: This study involved a 58 years old female patient with CKD and liver cirrhosis long years ago, underwent living-donor kidney and liver transplant procedure in September 2021, and was admitted in ICU for one week. Few months later, investigation revealed poor kidney function and renal graft nephrectomy was done in December 2021. Patient was admitted one week in ICU after renal graft nephrectomy. Core muscles, lower limb muscles and physical abilities were measured pre and post ICU admission after renal graft nephrectomy and at the time of discharge from physical therapy service. Result: Motor power was measured before renal graft nephrectomy and ICU admission classified and measured as follows: core muscles, hip flexors, adductors and abductors graded 3/5, hams and quad graded 3+/5, patient was able to stand up from sitting on regular chair and able to walk without assistance. Post renal graft nephrectomy and ICU admission the MRC was as follows: core muscles, hip flexors, adductors and abductors graded 2-/5, hams and quad graded 3-/5, patient was unable to stand up from regular chair and has poor standing balance. Patient was followed up in physical therapy eight weeks in total, four weeks in in-patient setting and four week in OPD. The discharge assessment shows improvement in hams and quad motor power measured 4/5, good core muscles and hip muscles measured 4/5. Patient was ambulatory without assistive device at the time of discharge from physical therapy service. Conclusion: Short-term ICU admission can acquired weakness if patient has repeated ICU admissions within short period

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Enhanced recovery after surgery programs improve short‐term outcomes after liver transplantation–A systematic review and meta‐analysis

Cited by 29 publications

References 40 publications

Abdominal Organ Transplantation: Noteworthy Literature in 2021

Abdominal Organ Transplantation: Noteworthy Literature in 2021

The Edge of Unknown: Postoperative Critical Care in Liver Transplantation

A Case of Short- Term Intensive Care Unit-Acquired Weakness Post-Renal Graft Nephrectomy after Liver and Kidney Transplant

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