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| IJCEM Copyright © 2008-All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711 |
Int J Clin Exp Med 2013;6(5):351-357
Original Article
Influence of preoperative diastolic dysfunction on hemodynamics and outcomes of
patients undergoing orthotopic liver transplantation
Zhen-Dong Xu, Hai-Tao Xu, Wei-Wei Li, Zui Zou, Xue-Yin Shi
Department of Anesthesiology, Shanghai First Maternity and Infant Health Hospital, Tongji University School of Medicine, 536 Changle
Road, Shanghai 200040, P.R. China; Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, 415
Fengyang Road, Shanghai 200003, P.R. China. Equal contributors.
Received March 20, 2013; Accepted April 25, 2013; Epub May 22, 2013; Published June 1, 2013
Abstract: Objective: Left ventricular diastolic dysfunction is receiving more attention in patients with end-stage liver diseases. The
importance of diastolic dysfunction observed before orthotopic liver transplantation (OLT) and its adverse effects on hemodynamics
and outcomes of OLT patients, have not been fully explored. We carried a retrospective study to investigate the influence of diastolic
dysfunction on OLT patients. Methods: Included in this retrospective study were 330 consecutive patients scheduled for cadaveric OLT
over a 5-year period. According to preoperative Doppler echocardiogram (ECHO) findings, patients were divided into two groups: DD
group (patients with diastolic dysfunction) and control group (patients with normal ECHO). Patient characteristics, operation variables,
hemodynamic course, blood products and drug requirements, postoperative courses and outcomes were evaluated. Results: 306
patients met the study entry criteria and 100 had preoperative diastolic dysfunction. Mean artery blood pressure was significantly lower
in DD group after graft reperfusion than that in control group (P<0.01). More patients in DD group required epinephrine, and the mean
dose of epinephrine was higher in DD group than that in control group (P<0.01). There was no significant difference in postoperative
ventilation time, duration of ICU and hospital stay, renal failure and postoperative mortality between the two groups. Conclusion:
Diastolic dysfunction is common in liver transplant recipients. Patients with diastolic dysfunction may be associated with substantial
hemodynamic alterations after graft reperfusion and need more inotropic support during OLT. Diastolic dysfunction was not associated
with significant adverse postoperative outcomes. (IJCEM1303014).
Keywords: Anesthesia, liver transplantation, intraoperative complications, postoperative complications, echocardiography
Address correspondence to: Dr. Xue-Yin Shi, Department of Anesthesiology, Changzheng Hospital, Second Military Medical University,
415 Fengyang Road, Shanghai 200003, P.R. China. Phone: +86-13601682827; E-mail: shixueyin1128@163.com
Original Article
Influence of preoperative diastolic dysfunction on hemodynamics and outcomes of
patients undergoing orthotopic liver transplantation
Zhen-Dong Xu, Hai-Tao Xu, Wei-Wei Li, Zui Zou, Xue-Yin Shi
Department of Anesthesiology, Shanghai First Maternity and Infant Health Hospital, Tongji University School of Medicine, 536 Changle
Road, Shanghai 200040, P.R. China; Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, 415
Fengyang Road, Shanghai 200003, P.R. China. Equal contributors.
Received March 20, 2013; Accepted April 25, 2013; Epub May 22, 2013; Published June 1, 2013
Abstract: Objective: Left ventricular diastolic dysfunction is receiving more attention in patients with end-stage liver diseases. The
importance of diastolic dysfunction observed before orthotopic liver transplantation (OLT) and its adverse effects on hemodynamics
and outcomes of OLT patients, have not been fully explored. We carried a retrospective study to investigate the influence of diastolic
dysfunction on OLT patients. Methods: Included in this retrospective study were 330 consecutive patients scheduled for cadaveric OLT
over a 5-year period. According to preoperative Doppler echocardiogram (ECHO) findings, patients were divided into two groups: DD
group (patients with diastolic dysfunction) and control group (patients with normal ECHO). Patient characteristics, operation variables,
hemodynamic course, blood products and drug requirements, postoperative courses and outcomes were evaluated. Results: 306
patients met the study entry criteria and 100 had preoperative diastolic dysfunction. Mean artery blood pressure was significantly lower
in DD group after graft reperfusion than that in control group (P<0.01). More patients in DD group required epinephrine, and the mean
dose of epinephrine was higher in DD group than that in control group (P<0.01). There was no significant difference in postoperative
ventilation time, duration of ICU and hospital stay, renal failure and postoperative mortality between the two groups. Conclusion:
Diastolic dysfunction is common in liver transplant recipients. Patients with diastolic dysfunction may be associated with substantial
hemodynamic alterations after graft reperfusion and need more inotropic support during OLT. Diastolic dysfunction was not associated
with significant adverse postoperative outcomes. (IJCEM1303014).
Keywords: Anesthesia, liver transplantation, intraoperative complications, postoperative complications, echocardiography
Address correspondence to: Dr. Xue-Yin Shi, Department of Anesthesiology, Changzheng Hospital, Second Military Medical University,
415 Fengyang Road, Shanghai 200003, P.R. China. Phone: +86-13601682827; E-mail: shixueyin1128@163.com
