Influence of retrograde flushing via the caval vein on the post-reperfusion syndrome in liver transplantation


Kniepeiss Daniela, MD, Department of Surgery, Division of Transplantation, University Hospital Graz, Auenbruggerplatz 29, Postfach 89, 8036 Graz, Austria.
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Abstract:  Introduction:  The reperfusion phase during orthotopic liver transplantation (LTX) is a critical event with sometimes profound hemodynamic and cardiac changes. We present the influence of retrograde reperfusion in LTX on the post-reperfusion syndrome (PRS).

Methods:  Fifty-six LTXs in 53 patients were performed with the piggy-back technique with retrograde reperfusion via the caval vein and antegrade reperfusion via the portal vein. The incidence of PRS was evaluated.

Results:  We observed a PRS in two patients (3.6%), four patients (7.1%) had a decrease in mean arterial pressure (MAP) of 20–29%, 18 patients (32.2%) of 10–19%, 27 patients (48.2%) of 1–9% and five patients (8.9%) had a small increase in MAP.

Discussion:  Our retrospective study showed that retrograde reperfusion seems to maintain stability during the reperfusion phase. Hemodynamic disturbances during LTX were uncommon, leading us to suppose that the incidence of PRS could be diminished with retrograde reperfusion.