Articles Vol. 66 No. CĐ13- HNKH Gây mê Hồi sức 25/09/2025

53. HEMODYNAMIC CHANGES DURING THE REPERFUSION PHASE IN PATIENTS WITH LIVER TRANSPLANTS FROM BRAIN-DEAD DONORS AT VIET DUC HOSPITAL FROM 2024-2025

Dao Thi Kim Dung1, Nguyen Duc Thien1, Ngo Van Thao1, Dang Tuấn Quang1, Ngo Manh Dinh1, Tran Thi Nuong1
1 Trung tâm Gây mê và Hồi sức ngoại khoa - Bệnh viện Hữu nghị Viêt Đức
Corresponding author: quangdt96.hmu@gmail.com
DOI: 10.52163/yhc.v66iCD13.3225
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Keywords
Liver transplantation, hemodynamics, reperfusion syndrom, classical technique, piggyback technique, brain-dead donor.
Abstract

Objective: Describe the hemodynamic changes during the reperfusion phases in patients with liver transplants from brain-dead donors at Viet Duc University Hospital from 2024 to 2025.

Subjects and methods: A cross-sectional, retrospective study on patients with liver transplants from brain-dead donors from January 2024 to June 2025. The study indicators include: age, gender, indication for liver transplant, MELD score preoperative, inferior vena cava clamping technique, blood loss, blood transfusion, warm ischemia time, cold ischemia time, operative time; pulse, systolic blood pressure, diastolic blood pressure, mean blood pressure at the time points: before and after inferior vena cava clamping, before and after reperfusion clamp release.

Results: 40 patients were included in the analysis. Blood pressure reduction of more than 30% during reperfusion occurred in 55% of patients. Bradycardia occurred in 42.5% and asystole occurred in 12.5% of patients. Patients with Child-Pugh C cirrhosis had a rate of hemodynamic disturbances during reperfusion of 100%, significantly higher than the groups of patients with Child-Pugh A and B. In the group of patients using classical techniques, the rate of hemodynamic disturbances during reperfusion was 90.5%, significantly higher than the group using piggyback technique. There were significant differences in MELD score, operative time and warm ischemia time between the two groups. There were no significant differences in age, cold ischemia time, blood loss and blood product transfusion during surgery between the two groups.

References
[1]
Manning M.W, Kumar P.A, Maheshwari K et al. Post-Reperfusion Syndrome in Liver Transplantation-An Overview. J Cardiothorac Vasc Anesth, 2020, 34 (2), 501-511. Google Scholar
[2]
Saman Nikeghbalian, Mohammad Naser Toutouni, Heshmatollah Salahi, Mohsen Aliakbarian, Seyed Ali Malekhosseini. A comparative study of the classic and piggyback techniques for orthotopic liver transplantation. Electronic physician, January-March 2014, volume 6, issue 1. Google Scholar
[3]
Cesaretti M, Izzo A, Pellegrino R.A et al. Cold ischemia time in liver transplantation: An overview. World J Hepatol, 2024, 16 (6), 883-890. Google Scholar
[4]
Hilmi I, Horton C.N, Planinsic R.M et al. The impact of postreperfusion syndrome on short-term patient and liver allograft outcome in patients undergoing orthotopic liver transplantation. Liver Transpl, 2008, 14 (4), 504-508. Google Scholar
[5]
Aggarwal S, Kang Y, Freeman J.A, Fortunato F.L, Pinsky M.R. Postreperfusion syndrome: cardiovascular collapse following hepatic reperfusion during liver transplantation. Transplant Proc, 1987, 19 (4 Suppl 3): 54-55. Google Scholar
[6]
Chung I.S, Kim H.Y, Shin Y.H et al. Incidence and predictors of post-reperfusion syndrome in living donor liver transplantation. Clin Transplant, 2012, 26 (4): 539-543. Google Scholar
[7]
Bukowicka B, Akar R.A, Olszewska A, Smoter P, Krawczyk M. The occurrence of postreperfusion syndrome in orthotopic liver transplantation and its significance in terms of complications and short-term survival. Ann Transplant, 2011, 16 (2): 26-30. Google Scholar
[8]
Sahmeddini M.A, Tehran S.G, Khosravi M.B et al. Risk factors of the post-reperfusion syndrome during orthotopic liver transplantation: a clinical observational study. BMC Anesthesiol, 2022, 22 (1): 89. Google Scholar
[9]
Ruiz de Azúa-López Z, Naranjo-Izurieta J.R, Lameirao J et al. Cold Ischemia Time as a Factor in Post-transplantation Complications for Orthotopic Hepatic Transplantation. Transplant Proc, , 201; 50 (2): 637-639. Google Scholar
[10]
Huguet C, Gavelli A, Chieco P.A et al. Liver ischemia for hepatic resection: where is the limit? Surgery, 1992, 111 (3): 251-259. Google Scholar
[11]
Henriksen J.H, Møller S. Cardiac and systemic haemodynamic complications of liver cirrhosis. Scand Cardiovasc J SCJ, 2009, 43 (4): 218-225. Google Scholar
[12]
Khosravi M.B, Sattari H, Ghaffaripour S et al. Post-reperfusion Syndrome and Outcome Variables after Orthotopic Liver Transplantation. Int J Organ Transplant Med, 2010, 1 (3): 115-120. Google Scholar