Fluid management in living donor hepatectomy:Recent issues and perspectives

The importance of the safety of healthy living liver donors is widely recognized during donor hepatectomywhich is associated with blood loss, transfusion, and subsequent post-operative morbidity. Although the low central venous pressure(CVP) technique can still be effective, it may not be advantageo...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2015-12, Vol.21 (45), p.12757-12766
Main Authors: Choi, Seong-Soo, Kim, Sung-Hoon, Kim, Young-Kug
Format: Article
Language:English
Subjects:
Blood Loss, Surgical - prevention & control
Crystalloid Solutions
Donor
Fluid Therapy - adverse effects
Fluid Therapy - methods
hepatectomy
Central
Humans
Isotonic Solutions - administration & dosage
Isotonic Solutions - adverse effects
Liver Transplantation - adverse effects
Liver Transplantation - methods
Living Donors
Monitoring, Intraoperative - methods
Predictive Value of Tests
pressure
Stroke
Review
Stroke Volume
Treatment Outcome
venous
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Summary:The importance of the safety of healthy living liver donors is widely recognized during donor hepatectomywhich is associated with blood loss, transfusion, and subsequent post-operative morbidity. Although the low central venous pressure(CVP) technique can still be effective, it may not be advantageous concerning the safety of healthy donors undergoing hepatectomy. Emerging evidence suggests that stroke volume variation(SVV), a simple and useful index for fluid responsiveness and preload status in various clinical situations, can be applied as a guide for fluid management to reduce blood loss during living donor hepatectomy. Synthetic colloid solutions are also associated with serious adverse events such as the use of renal replacement therapy and transfusion in critically ill or septic patients. However, it is uncertain whether the intra-operative use of colloid solution is associated with similarly adverse effects in patients undergoing living donor hepatectomy. In this review article we discuss the recent issues regarding the low CVP technique and the high SVV method, i.e., maintaining 10%-20% of SVV, for fluid management in order to reduce blood loss during living donor hepatectomy. In addition, we briefly discuss the effects of intra-operative colloid or crystalloid administration for surgical rather than septic or critically ill patients.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v21.i45.12757