Anesthetic Experiences of Liver Transplantation in a New Low Volume Hospital: Ewha Womans University Mokdong Hospital.
10.12771/emj.2017.40.4.143
- Author:
So Hee JIN
1
;
Rack Kyung CHUNG
;
Jae Hee WOO
;
Geun HONG
Author Information
1. Department of Anesthesiology and Pain Medicine, Ewha Womans University College of Medicine, Seoul, Korea. rkchung@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
Liver transplantation;
Anesthesia;
Hospitals, low-volume
- MeSH:
Adult;
Anesthesia;
Calcium;
Ephedrine;
Epinephrine;
Female;
Hepatitis B;
Hospitals, Low-Volume;
Humans;
Intensive Care Units;
Korea;
Liver Cirrhosis;
Liver Diseases;
Liver Failure;
Liver Transplantation*;
Liver*;
Living Donors;
Mortality;
Norepinephrine;
Pneumonia;
Postoperative Complications;
Retrospective Studies;
Survival Rate;
Tissue Donors
- From:The Ewha Medical Journal
2017;40(4):143-148
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES: Liver transplantation (LT) is the only treatment for end stage of liver failure. In Korea, annually it has been performed 1,300 cases. Most of LTs are performed in large volumes centers. More than half of centers performing LT in Korea are low volume hospital and started a LT program recently. We present our four-year experiences and outcomes of anesthesia for LT since 2013. METHODS: Anesthetic and surgical outcomes of 49 consecutive patients who received LT (living donor LT, 21 cases; deceased donor LT, 28 cases) between April 2013 and April 2017 were analyzed retrospectively. RESULTS: All patients were adult, with the mean age of 53.5±9.2 years. The most common cause of original liver diseases was hepatitis B virus-related liver cirrhosis (40.8%). The mean MELD (Model for End-stage Liver Disease) score was 18.8±10.7. Postreperfusion syndrome was observed in 34.7%, which were all controlled by calcium, norepinephrine, ephedrine and epinephrine. The mean postoperative intensive care unit stay of deceased donor LT recipients (13.6±9.0 days) was significantly longer than that of living donor LT recipients (8.0±3.3 days). There was no intraoperative mortality in patients receiving LT. Thirty-day post-transplant survival rate was 93.8% and 3-year survival rate was 88.6 %. The most common postoperative complication was pneumonia. CONCLUSION: We have started LT successfully with multidisciplinary team's steady effort. Adaptation and setting up LT protocol, adequate equipment, proper training at established transplant centers are essential to begin a successful LT program.
