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Systemic-to-Pulmonary Artery Pressure Ratio as a Predictor of Patient Outcome Following Liver Transplantation

Nguyen, Dung ; Rebel, Annette ; Hassan, Zaki-Udin ; Sloan, Paul A ; Bauer, Brooke ; DiLorenzo, Amy 2016

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  • Title:
    Systemic-to-Pulmonary Artery Pressure Ratio as a Predictor of Patient Outcome Following Liver Transplantation
  • Author: Nguyen, Dung ; Rebel, Annette ; Hassan, Zaki-Udin ; Sloan, Paul A ; Bauer, Brooke ; DiLorenzo, Amy
  • Subjects: Outcome ; Hepatology ; Anesthesiology ; Right heart function ; Morbidity ; Liver transplantation
  • Description: AIM To assess the value of the mean systemic-to-pulmonary artery pressure (MAP/mPAP) ratio for predicting outcomes following orthotopic liver transplant (OLT). METHODS A retrospective data analysis was performed and data (mean arterial blood pressure, mean pulmonary artery pressure and Cardiac Index) were collected at several points during OLT. Outcomes evaluated were duration of postoperative endotracheal intubation [ET; minutes after intensive care unit (ICU) arrival], length of ICU stay, total hospitalization and frequency of immediate postoperative complications. A total of 91 patients were included in the data analysis. Based on the intraoperative course of the MAP/mPAP ratio, 2 hemodynamic responses were identified: Group 1 (MAP/mPAP ratio increase during anhepatic period with postreperfusion recovery, n = 66); and Group 2 (MAP/mPAP ratio with no change during anhepatic period or decreased without recovery, n = 25). RESULTS The main finding was that the lack of increased MAP/mPAP ratio in the anhepatic period was associated with: (1) longer intubation times; and (2) prolonged ICU stays and total hospitalization time, when compared to patients with an increase in MAP/mPAP ratio during the anhepatic period. CONCLUSION The data from this retrospective study should raise awareness to the mean systemic to pulmonary artery pressure ratio as a potential indicator for poor outcome after OLT. Further prospective studies are needed for validation.
    Published in World Journal of Hepatology, v. 8, 32, p, 1384-1391. ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved. This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
  • Creation Date: 2016
  • Language: English
  • Identifier: DOI: 10.4254/wjh.v8.i32.1384
  • Source: UKnowledge

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