Cardiopulmonary arrest in liver transplantation surgery: Perioperative beta-blockade implication in the cirrhotic patient

Abstract

Liver transplantation (LT) has an incidence of intraoperative cardiopulmonary arrest (CPA) of around 5%. Patients who experience CPA during this procedure have a reduced survival rate of approximately 50%.

Most CPAs occur during the neohepatic phase due to reperfusion syndrome, but this is not always the underlying cause, and a broad differential diagnosis must be performed.

We introduce the case of a cirrhotic patient who received beta-blocker therapy in the preoperative period and who experienced intraoperative CPA during LT surgery, which was successfully resolved through advanced cardiopulmonary resuscitation (CPR) maneuvers and specific treatment for beta-blocker toxicity (calcium and glucagon).