Cell and Organ Transplantology. 2014; 2(2):122-126.
Treatment of the early postoperative complications following liver transplantation
Rummo O. O.
Republican Scientific Practical Center for Organ and Tissue Transplantation, Minsk, Belarus
Despite considerable reduction of the lethality rate after ortotopic liver transplantation and owing to the achievements in modern surgery, immunology and anesthesiology, the early postoperative complications still occur in nearly 70 % and can significantly compromise patient survival.
The aim of this study was to assess the frequency and causes of early post-transplantation complications and to develop effective means for their prophylaxis and treatment.
Materials and methods. Within the period from 03.04.2008 to 01.07.2014, altogether 260 liver transplantations were performed in 252 recipients in the Republican Center for organ and tissue transplantation (Minsk, Belarus: of them 209 (81.2 %) according to the classic technique, 46 (17.7 %) cavaplasty and 5 portal transposition (2.4 %).
Thirty-six liver transplantations (13.9 %) were performed in children before 18 years of age. The strategy of peri-operative techniques and immune-suppressive therapy were the same for all patients.
Results. Vascular complications occurred in 44 cases (16.9 %), biliary complications in 46 (17.7 %), acute kidney injury in 47 (18.1 %), primary non-functioning after 3 liver transplantations (1.2 %), early allograft dysfunction in 71 (27.3 %) cases, and bacterial complications after 66 (25.4 %) liver transplantations. Predictors of early allograft dysfunction were thermal ischemia and graft steatosis. Three-year patients’ survival was 85 %.
Conclusion. The main cause of death was multiple organ failure developed in a sign of bacterial complications and early allograft dysfunction. Significant role in early postoperative complications prophylaxis acts interdisciplinary prevention of nosocomial infection.
Key words: liver transplantation; early postoperative complications; macrovesicular steatosis; warm ischemia timeFull Text PDF (eng) Full Text PDF (ru)
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Rummo OO. Тreatment of the early postoperative complications following liver transplantation. Cell and Organ Transplantology. 2014; 2(2):122-126. doi: 10.22494/COT.V2I2.33