Intraoperative Cardiac Arrests in Asian Recipients of Liver Transplantation—Second Report After Learning Curve

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2024-12-21 DOI:10.1111/ctr.70038

Jisun Choi, SangHyun Lee, Justin Sangwook Ko, Mi Sook Gwak, Gaab Soo Kim

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引用次数: 0

Abstract

Background

Although surgical competency and anesthesia for liver transplantation (LT) have evolved significantly in the past decades, intraoperative cardiac arrest (ICA) is still an event that brings a poor prognosis to the recipient. We report a second-decade experience of ICA as a follow-up study of our first report at our institution.

Methods

This is a retrospective observational study of the medical records and the Liver Transplant Program database of our institution. LT from January 2011 to June 2023 were included. Of the 1735 LT cases, a total of 1730 cases were included, excluding three non-Asian and two simultaneous heart and liver transplants (1598 adult LT, 132 pediatric LT).

Results

The ICA incidence during adult LT was 0.7% (11/1598) which is significantly lower compared to our first report (1.5%; 14/919) (p = 0.042). ICA occurred only in adult recipients. Post-reperfusion syndrome (PRS, six cases) and bleeding (four cases) were the primary causes in most cases and most ICA occurred after reperfusion (10/11). The mortality rates within 24 h, 30 days, and 1 year were 27.3%, 45.5%, and 54.5%, respectively. The survival curve did not show a significant difference from our first report (p = 0.570), and the survival rate of the ICA group was significantly lower compared to the non-ICA group. (p = 0.000)

Conclusion

The incidence of ICA has decreased, but the main causes of ICA as PRS and bleeding after reperfusion have not changed. Additionally, there was no significant difference in the survival curves from the first report. Because ICA is still fatal, efforts to reduce its incidence should be continued.

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.