Fenoldopam and Gastric Tonometry During Orthotopic Liver Transplantation

Pugliese, Francesco; Ruberto, Franco; Bruno, Katelyn A.; Martelli, S.; Perrella, S.; Cappannoli, A.; DaLio, Andrew L.; Messina, Teresa; Summonti, D; Pietropaoli, C.; Rossi, Massimo; Novelli, G.; Berloco, P.; Pietropaoli, P

doi:10.1016/j.transproceed.2007.05.063

Cited by 2 publications

(4 citation statements)

References 9 publications

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“…45-48 We included 25 RCTs ( Figure S1, SDC , http://links.lww.com/TP/C835; Table 1). 49-73 Detailed interventions and main cointerventions used in individual studies (fluid management and coagulation management protocols) are reported in Table 1. All studies were conducted in patients of similar age, disease type, and severity, although the type of donation was heterogeneously reported (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Based on very low QoE, no effect of somatostatin was observed regarding biliary stenosis or acute rejection, and none of the studies observed an event of graft dysfunction in either group (Table 4; Table S20 and Figure S11, SDC , http://links.lww.com/TP/C835). Two studies comparing different vasodilator infusions reported the incidence of graft dysfunction 64,66 and 1 reported the incidence of biliary complications 71 (Table 1; Tables S1 and S4, SDC , http://links.lww.com/TP/C835). Based on very low QoE, no effect was observed from either vasodilator (Table 5; Table S29 and Figure S14, SDC , http://links.lww.com/TP/C835).…”

Section: Resultsmentioning

confidence: 99%

“…Based on very low QoE, no effect of somatostatin was observed regarding biliary stenosis or acute rejection, and none of the studies observed an event of graft dysfunction in either group (Table 4; Table S20 and Figure S11, SDC, http://links.lww.com/TP/C835). Two studies comparing different vasodilator infusions reported the incidence of graft dysfunction 64,66 and 1 reported the Fenoldopam 45 [42][43][44][45][46][47][48][49][50] 11 (24) -72 ( 18) 46 (100) 0 (0) --535 (155) 0 (0) Low-dose dopamine 50 [46][47][48][49][50][51][52][53][54]…”

Section: Graft Complicationsmentioning

confidence: 99%

“…[58][59][60] Overall, based on very low QoE, a somatostatin infusion or its analogue did not improve these outcomes (Table 4; Table S19 and Figure S10, SDC, http://links.lww.com/TP/C835). Four studies comparing vasodilator infusions reported the incidence of AKI, 61,64,70,71 3 reported the incidence of AKI requiring RRT 61,64,71 and 7 reported creatinine levels at 24, 48, 72 h and 5 d after surgery [61][62][63][64][65][66][67] (Table 1; Tables S1 and S4, SDC, http://links.lww.com/TP/C835). Overall, based on low to very low QoE, no vasodilator seems better to decrease the incidence of AKI (Table 5; Tables S23 and S24 and Figure S15, SDC, http://links.lww.com/TP/C835).…”

Section: Akimentioning

confidence: 99%

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Intraoperative Vasoactive Medications and Perioperative Outcomes in Liver Transplantation: A Systematic Review and Network Meta-analyses

et al. 2023

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We conducted a systematic review and network meta-analyses evaluating the effects of different intraoperative vasoactive drugs on acute kidney injury (AKI) and other perioperative outcomes in adult liver transplant recipients. We searched multiple electronic databases using words from the “liver transplantation” and “vasoactive drug” domains. We included all randomized controlled trials conducted in adult liver transplant recipients comparing 2 different intravenous vasoactive drugs or 1 against a standard of care that reported AKI, intraoperative blood loss, or any other postoperative outcome. We conducted 4 frequentist network meta-analyses using random effect models, based on the interventions’ mechanism of action, and evaluated the quality of evidence (QoE) using Grading of Recommendations, Assessment, Development, and Evaluations recommendations. We included 9 randomized controlled trials comparing different vasopressor drugs (vasoconstrictor or inotrope), 3 comparing a somatostatin infusion (or its analogues) to a standard of care, 11 comparing different vasodilator infusions together or against a standard of care, and 2 comparing vasoconstrictor boluses at graft reperfusion. Intravenous clonidine was associated with shorter duration of mechanical ventilation, intensive care unit, and hospital length of stay (very low QoE), and some vasodilators were associated with lower creatinine level 24 h after surgery (low to very low QoE). Phenylephrine and terlipressin were associated with less intraoperative blood loss when compared with norepinephrine (low and moderate QoE). None of the vasoactive drugs improve any other postoperative outcomes, including AKI. There is still important equipoise regarding the best vasoactive drug to use in liver transplantation for most outcomes. Further studies are required to better inform clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Based on very low QoE, no effect of somatostatin was observed regarding biliary stenosis or acute rejection, and none of the studies observed an event of graft dysfunction in either group (Table 4; Table S20 and Figure S11, SDC, http://links.lww.com/TP/C835). Two studies comparing different vasodilator infusions reported the incidence of graft dysfunction 64,66 and 1 reported the Fenoldopam 45 [42][43][44][45][46][47][48][49][50] 11 (24) -72 ( 18) 46 (100) 0 (0) --535 (155) 0 (0) Low-dose dopamine 50 [46][47][48][49][50][51][52][53][54]…”

Section: Graft Complicationsmentioning

confidence: 99%