Transfusion Requirements During Liver Transplantation: Impact of a Temporary Portacaval Shunt

Suárez-Muñoz, Miguel Ángel; Santoyo-Santoyo, Julio; Fernández-Aguilar, José Luis; Sánchez-Pérez, Belinda; Pérez-Daga, J.A.; Ramírez-Plaza, César Pablo; Cañete, A.

doi:10.1016/j.transproceed.2006.08.045

Cited by 13 publications

(32 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A direct comparison of the operative times with and without TPCS was available in 3 studies. 9,10,14 There was no difference in 2 studies, 9,14 and 1 study found that the operative time was shorter in patients undergoing TPCS. 10 The intraoperative blood product transfusion requirement was described in 6 articles.…”

Section: Resultsmentioning

confidence: 91%

“…9,10,14 There was no difference in 2 studies, 9,14 and 1 study found that the operative time was shorter in patients undergoing TPCS. 10 The intraoperative blood product transfusion requirement was described in 6 articles. 1,3,8,10,13,14 The number of red blood cell units transfused into patients with a TPCS ranged from 1.1 Ϯ 2.3 to 98.4 Ϯ4.3 units.…”

Section: Resultsmentioning

confidence: 91%

“…Results from the 8 included articles are summarized in Tables 1 and 2, including a total of 2073 patients. 1,3,[8][9][10][11][12][13] The indication for transplantation was given for 647 recipients. The majority of patients had chronic liver disease (95.51%), with the remainder (4.49%) being transplanted for acute liver failure.…”

Section: Resultsmentioning

confidence: 99%

“…10 The intraoperative blood product transfusion requirement was described in 6 articles. 1,3,8,10,13,14 The number of red blood cell units transfused into patients with a TPCS ranged from 1.1 Ϯ 2.3 to 98.4 Ϯ4.3 units. A comparison of patients with a TPCS and patients without one was reported in 3 articles.…”

Section: Resultsmentioning

confidence: 99%

“…A comparison of patients with a TPCS and patients without one was reported in 3 articles. 10,13,14 Two of 3 studies found that a TPCS was associated with less red blood cell requirement. 13,14 The amount of fresh frozen plasma transfused into patients with a TPCS ranged from 1.4 Ϯ2.7 to 19 Ϯ14.7 units.…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Temporary portocaval shunt in orthotopic liver transplantation: Need for a standardized approach?

2008

View full text Add to dashboard Cite

Maintenance of portal and systemic venous return during the anhepatic phase of liver transplantation (LT) improves hemodynamic stability. With the piggyback technique, caval return is maintained; however, temporary clamping of the portal vein is still necessary. The use of a temporary portocaval shunt (TPCS) has been proposed to minimize the effect of portal venous interruption. The aim of this study was to perform a systematic review of the literature to determine whether there is evidence to support the routine use of a TPCS in LT. An electronic search of the literature from 1963 to 2007 was performed. A total of 4386 articles were identified, of which 8 met all the criteria and were included in the study. Because of the variability in reporting and the small number of studies, statistical comparison was not possible; however, a trend toward a shorter operative time, less blood product transfusion, and maintenance of higher mean arterial pressures during portal vein clamping was seen in patients with a TPCS. In conclusion, the available evidence, albeit scarce, supports the use of a TPCS in patients undergoing LT. A prospective randomized study of patients most likely to benefit from a TPCS is necessary to substantiate these findings.

show abstract

Section: Resultsmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Temporary portocaval shunt in orthotopic liver transplantation: Need for a standardized approach?

2008

View full text Add to dashboard Cite

show abstract

Prediction of the binding mode between GSK3β and a peptide derived from GSKIP using molecular dynamics simulation

Tang

Chuang

et al. 2011

Biopolymers

View full text Add to dashboard Cite

GSK3β plays an important role in many physiological functions; dysregulated GSK3β is involved in human diseases such as diabetes, cancer, and Alzheimer's disease. This study uses MD simulations to determine the interaction between GSK3β and a peptide derived from GSKIP, a novel GSK3β interacting protein. Results show that GSKIPtide is inlaid in a binding pocket consisting of an α-helix and an extended loop near the carboxy-terminal end. This binding pocket is hydrophobic, and is responsible for the protein-protein interaction of two other GSK3β interacting proteins: FRAT and Axin. The GSKIPtide binding mode is closer to that of AxinGID (in the Axin-GSK3-interacting domain). The single-point mutations of V267G and Y288F in GSK3β differentiate the binding modes between GSK3 and GSKIPtide, AxinGID, and FRATide. The V2677G mutation of GSK3β reduces the GSKIPtide binding affinity by 70% and abolishes the binding affinity with AxinGID, but has no effect on FRATide. However, GSK3β Y288F completely abolishes the FRATide binding without affecting GSKIPtide or AxinGID binding. An analysis of the GSK3β-GSKIPtide complex structure and the X-ray crystal structures of GSK3β-FRATide and GSK3β-AxinGID complexes suggests that the hydroxyl group of Y288 is crucial to maintaining a hydrogen bond network in GSK3β-FRATide. The hydrophobic side chain of V267 maintains the integrity of helix-helix ridge-groove hydrophobic interaction for GSK3β-GSKIPtide and GSK3β-AxinGID. This study simulates these two mutant systems to provide atomic-level evidence of the aforementioned experimental results and validate the wild-type complex structure prediction.

show abstract

Vena cava encirclement predicts difficult native hepatectomy

Panaro

Boisset

Chanques³

et al. 2016

Liver Transpl

View full text Add to dashboard Cite

Recipient hepatectomy is a challenging liver transplantation (LT) procedure that has life-threatening complications. The current predictive mortality clinic-biological scores (Child/Model for End-Stage Liver Disease [MELD]) do not take into consideration the recipient's liver anatomy. The aim of this study was to evaluate the impact of the dorsal sector anatomy of a cirrhotic liver on the morbidity/mortality rates of hepatectomy. A multicenter retrospective study (clinic-biological and morphologic) was performed from 2013 to 2014. The degree of encirclement of the inferior vena cava (IVC) by the dorsal sector of the liver was measured. The study population included 320 patients. Seventyfour (23%) patients had complete IVC encirclement. A correlation (P 5 0.01) has been reported between the existence of a circular dorsal sector and the number of transfusions during LT (4 packed red blood cell [PRBC] transfusions in the group without IVC versus 7 PRBC transfusions in the other group). The existence of such anatomy increases the relative risk of early reoperation for IVC bleeding by 31% (P 5 0.05). There is a correlation between alcoholic cirrhosis and dorsal-sector hypertrophy (126 cc versus 147.5 cc; P 5 0.05). Concerning surgical time, we found no significant between-group differences. Compared to the severity of cirrhosis, an inverse correlation was observed between the MELD and Child scores and the dorsal sector hypertrophy (P < 0.001). No significant difference in terms of transfusion was found between the temporary portocaval shunt group (n 5 168) and the other group (n 5 152). The presence of a circular sector is associated with an increased risk of hemorrhage during hepatectomy, as well as an immediate postoperative risk of reoperation.Liver Transplantation 22 906-913, 2016 AASLD. The first step in liver transplantation (LT) consists of a full hepatectomy. Initial LT techniques are required to replace the recipient's inferior vena cava (IVC) at the retrohepatic part. (1) Reconstruction techniques allowing for the preservation of the IVC have been described. (2) The hepatectomy represents the most difficult time during surgery, with life-threatening complications related to the risk of massive hemorrhage. In addition, the difficulty of hepatectomy is hard to define and to anticipate. There is no preoperative score that considers the morphological data of the native liver to anticipate hepatectomy difficulty; the existence of hypertrophy in the dorsal sector has been quoted by many authors, but there are few analyses of the surgical impact. The difficulty of hepatectomy seems to be related to the release of the IVC, and, thus, it depends on the hepatic segment in contact with the vein: the involved segments are segment I (S1) and segment IX (S9), according to Couinaud, (3) and anatomical variations of this hepatic sector are important.

show abstract

Transfusion Requirements During Liver Transplantation: Impact of a Temporary Portacaval Shunt

Cited by 13 publications

References 5 publications

Temporary portocaval shunt in orthotopic liver transplantation: Need for a standardized approach?

Temporary portocaval shunt in orthotopic liver transplantation: Need for a standardized approach?

Prediction of the binding mode between GSK3β and a peptide derived from GSKIP using molecular dynamics simulation

Vena cava encirclement predicts difficult native hepatectomy

Contact Info

Product

Resources

About