TY - JOUR
T1 - Extended Criteria Donor and Severe Intraoperative Glucose Variability
T2 - Association With Reoperation for Hemorrhage in Liver Transplantation
AU - Park, C.
AU - Huh, M.
AU - Steadman, R. H.
AU - Cheng, R.
AU - Hu, K. Q.
AU - Farmer, D. G.
AU - Hong, J.
AU - Duffy, J.
AU - Busuttil, R. W.
AU - Xia, V. W.
N1 - Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2010/6
Y1 - 2010/6
N2 - Reoperations for hemorrhage following liver transplantation (OLT) are commonly associated with increased morbidity and mortality. We sought to determine the incidence and risk factors for reoperation for hemorrhage among adult liver transplantations. We retrospectively analyzed 668 patients transplanted between January 2004 and November 2007. Within 30 days following transplantation one hundred eleven patients (16.6%) underwent 156 reoperations for hemorrhage, averaging 1.4 reoperations per patient. More than half of the reoperations occurred during the first 2 postoperative days. One-third of patients required 2 or more reoperations. Multivariate logistic regression analysis showed 4 independent risk factors: grafts from donors with multiple extended criteria, severe intraoperative glucose variability, intraoperative use of vasopressors, and red blood cell transfusion requirement. In conclusion, we identified several independent risk factors for reoperation due to hemorrhage following OLT. Avoidance of severe intraoperative glucose variability and careful evaluation of the benefits and risks of utilizing extended criteria donors must be considered before transplantation.
AB - Reoperations for hemorrhage following liver transplantation (OLT) are commonly associated with increased morbidity and mortality. We sought to determine the incidence and risk factors for reoperation for hemorrhage among adult liver transplantations. We retrospectively analyzed 668 patients transplanted between January 2004 and November 2007. Within 30 days following transplantation one hundred eleven patients (16.6%) underwent 156 reoperations for hemorrhage, averaging 1.4 reoperations per patient. More than half of the reoperations occurred during the first 2 postoperative days. One-third of patients required 2 or more reoperations. Multivariate logistic regression analysis showed 4 independent risk factors: grafts from donors with multiple extended criteria, severe intraoperative glucose variability, intraoperative use of vasopressors, and red blood cell transfusion requirement. In conclusion, we identified several independent risk factors for reoperation due to hemorrhage following OLT. Avoidance of severe intraoperative glucose variability and careful evaluation of the benefits and risks of utilizing extended criteria donors must be considered before transplantation.
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U2 - 10.1016/j.transproceed.2009.12.066
DO - 10.1016/j.transproceed.2009.12.066
M3 - Article
C2 - 20620513
AN - SCOPUS:77953670754
SN - 0041-1345
VL - 42
SP - 1738
EP - 1743
JO - Transplantation Proceedings
JF - Transplantation Proceedings
IS - 5
ER -