Enhanced recovery after surgery in liver transplantation: Challenges and feasibility

• Published in: World journal of transplantation 2022-07, Vol.12 (7), p.195-203
• Main Authors: Katsanos, Georgios, Karakasi, Konstantina-Eleni, Antoniadis, Nikolaos, Vasileiadou, Stella, Kofinas, Athanasios, Morsi-Yeroyannis, Antonios, Michailidou, Evangelia, Goulis, Ioannis, Sinakos, Emmanouil, Giouleme, Olga, Oikonomou, Ilias Marios, Evlavis, George, Tsakiris, Georgios, Massa, Eleni, Mouloudi, Eleni, Tsoulfas, Georgios
• Format: Article
• Language: English
• Subjects: Systematic Reviews
• ISSN: 2220-3230; 2220-3230
• DOI: 10.5500/wjt.v12.i7.195

BACKGROUNDEnhanced recovery after surgery (ERAS) started a revolution that changed age-old surgical stereotypical practices regarding the overall management of the surgical patient. In the last decade, ERAS has gained significant acceptance in the community of general surgery, in addition to several other surgical specialties, as the evidence of its advantages continues to grow. One of the last remaining fields, given its significant complexity and intricate nature, is liver transplantation (LT). AIMTo investigate the existing efforts at implementing ERAS in LT. METHODSWe conducted a systematic review of the existing studies that evaluate ERAS in orthotopic LT, with a multimodal approach and focusing on measurable clinical primary endpoints, namely length of hospital stay. RESULTSAll studies demonstrated a considerable decrease in length of hospital stay, with no readmission or negative impact of the ERAS protocol applied to the postoperative course. CONCLUSIONSERAS is a well-validated multimodal approach for almost all types of surgical procedures, and its future in selected LT patients seems promising, as the preliminary results advocate for the safety and efficacy of ERAS in the field of LT.