Orthotopic Liver Transplantation With Vena Cava Preservation in Cirrhotic Patients: Is Systematic Temporary Portacaval Anastomosis a Justified Procedure?

• Published in: Transplantation proceedings 2005-06, Vol.37 (5), p.2159-2162
• Main Authors: Muscari, F., Suc, B., Aguirre, J., Di Mauro, G.L., Bloom, E., Duffas, J.P., Blanc, P., Fourtanier, G.
• Format: Article
• Language: English
• Subjects: Female; Hepatic Veins - surgery; Humans; Liver Cirrhosis - surgery; Liver Transplantation - methods; Male; Middle Aged; Organ Preservation; Portacaval Shunt, Surgical; Reproducibility of Results; Retrospective Studies; Treatment Failure; Treatment Outcome; Vena Cava, Inferior - surgery
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2005.03.005

We evaluated the peri- and postoperative effects of the lack of a temporary portocaval anastomosis (TPCA) during orthotopic liver transplantation (OLT) in 84 patients with cirrhosis. From December 1996 to December 2002, 156 liver transplant recipients included (54%; 60 men and 24 women) of mean age 52 ± 9 years with portal hypertension. In whom peri- and postoperative data were analyzed. The median fall in mean arterial pressure upon vascular clamping and unclampings was 20 mm Hg (range 15 to 75), while the median duration of portal vein clamping was 77 minutes. The median amount of blood autotransfusion was 1100 mL (range 0 to 5400). The median number of red blood cell and fresh-frozen plasma units transfused were 5 and 6.5, respectively. The median intraoperative urinary output was 72 mL/h (range 11 to 221). Three patients (3.5%) presented a perioperative complication, but no perioperative death was observed. Six patients experienced an early postoperative complication (