Transplantation proceedings
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Randomized Controlled Trial Multicenter Study
Impact of 6% Starch 130/0.4 and 4% Gelatin Infusion on Kidney Function in Living-Donor Liver Transplantation.
Since the first liver transplantation, pretransplantation or post-transplantation renal problems are still among the main causes of mortality and morbidity. The aim of this study was to evaluate the effects of fluid replacement solutions used intraoperatively on renal functions in elective living-donor liver transplantation. ⋯ In conclusion, Gelofusine seem to cause more impairment in renal functions in elective living-donor liver transplantation.
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Hyperlactatemia may occur early after cardiac surgery and is correlated with prognosis. This study was conducted to analyze the perioperative variables and postoperative outcomes among heart transplant recipients with extremely high lactate levels (>15 mmol/L). ⋯ Extreme hyperlactatemia commonly occurred early after heart transplantation and mostly recovered within 30 hours; however, with delayed extubation time after operation.
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Postoperative renal impairment (RI) is one of the most common complications in orthotopic liver transplantation (OLT), and it occurs in 17% to 95% of the patients who undergo the surgery. ⋯ Perioperative use of HES 200/0.5 or HES 130/0.4 has no significant effect on renal function in the first postoperative week in patients undergoing OLT.
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Rotation thromboelastometry (ROTEM®) is increasingly used in liver transplantation (LT). Of the ROTEM® parameters, maximum clot firmness (MCF) of EXTEM (MCFEXT) and INTEM (MCFINT) are influenced by both platelet count (PLT) and fibrinogen concentration (FIB), whereas MCF of FIBTEM (MCFFIB) is solely influenced by FIB. We aimed to determine whether using MCFs of thromboelastometry could reliably predict both PLT and FIB and to evaluate their relations in patients with thrombocytopenia and hypofibrinogenemia during LT. ⋯ Both PLT and FIB can be reliably quantified by MCFs of thromboelastometry, reducing the needs for additional laboratory tests to know values of thrombocytopenia and hypofibrinogenemia in patients undergoing LT.
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Review Meta Analysis
Effect of Perioperative Terlipressin on Postoperative Renal Function in Patients Who Have Undergone Living Donor Liver Transplantation: A Meta-Analysis of Randomized Controlled Trials.
Recent studies have shown the efficacy of terlipressin on postoperative renal function in patients who have undergone living donor liver transplantation (LDLT). ⋯ An intravenous infusion of terlipressin perioperatively for LDLT has no effect on the creatinine values postoperatively. Larger randomized controlled trials on terlipressin infusions during liver transplantation are needed.