单位:[1]Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China临床科室麻醉科麻醉科首都医科大学附属北京友谊医院[2]Division of Liver Transplantation Surgery, Department of Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China临床科室国家中心普外分中心普外四科(肝脏移植外科)首都医科大学附属北京友谊医院[3]Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing, P.R. China临床科室国家中心普外分中心普外四科(肝脏移植外科)首都医科大学附属北京友谊医院
Backgrounds: Predicting the occurrence of severe postreperfusion syndrome (PRS) is clinically challenging. We investigated whether the flushed fluid potassium concentration (FFK) was associated with severe PRS in deceased donor liver transplantation (DDLT). Material/Methods: Forty adult DDLT recipients were enrolled in this retrospective study. Effluent solution samples were collected at the end of the portal vein flush, and the FFK was determined using a point-of-care blood gas analyzer. The risk factors associated with severe PRS and the clinical outcomes in 2 groups were compared. Results: Severe PRS occurred in 22 out of 40 patients (55.0%). The FFK of the severe PRS group was significantly higher than that of the non-severe PRS group (median, 9.6 vs. 5.8, P<0.001). Other variables associated with severe PRS included the donor risk index (DRI), Child-Turcotte-Pugh score, donor type, donor warm ischemia time, and Model for End-stage Liver Disease score. The area under the receiver operator characteristic curve for the FFK was 0.982, and the best cut-off value of the FFK for predicting severe PRS was 6.75 mmol/L (100.0% sensitivity and 88.9% specificity). A significant positive correlation was observed between the FFK and DRI (R=0.714). Patients who experienced severe PRS had a higher early allograft dysfunction rate (63.6% vs. 22.2%, P=0.019) and a longer hospital stay (median, 33.0 vs. 24.0, P=0.034). Conclusions: Both the severity of the recipient's liver disease and the donor graft factors play an important role in the development of severe PRS in DDLT. An FFK of more than 6.75 mmol/L was associated with severe PRS after reperfusion.
基金:
Beijing Municipal Science and Technology CommissionBeijing Municipal Science & Technology Commission [Z171100001017036]; Scientific Research Key Program of Beijing Municipal Commission of EducationBeijing Municipal Commission of Education [201510025026]
第一作者单位:[1]Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
通讯作者:
通讯机构:[2]Division of Liver Transplantation Surgery, Department of Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China[3]Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing, P.R. China
推荐引用方式(GB/T 7714):
Zhang Liang,Tian Ming,Sun Liying,et al.Association Between Flushed Fluid Potassium Concentration and Severe Postreperfusion Syndrome in Deceased Donor Liver Transplantation[J].MEDICAL SCIENCE MONITOR.2017,23:5158-5167.doi:10.12659/MSM.907132.
APA:
Zhang, Liang,Tian, Ming,Sun, Liying&Zhu, Zhijun.(2017).Association Between Flushed Fluid Potassium Concentration and Severe Postreperfusion Syndrome in Deceased Donor Liver Transplantation.MEDICAL SCIENCE MONITOR,23,
MLA:
Zhang, Liang,et al."Association Between Flushed Fluid Potassium Concentration and Severe Postreperfusion Syndrome in Deceased Donor Liver Transplantation".MEDICAL SCIENCE MONITOR 23.(2017):5158-5167