Enhanced recovery after surgery improves clinical outcomes of liver transplant recipients
10.3969/j.issn.1674-7445.2020.01.010
- VernacularTitle:加速康复外科方案改善肝移植受者结局
- Author:
Lijuan LI
1
;
Pinglan LU
;
Mi ZHOU
;
Xunan GONG
;
Jianrong LIU
;
Guihua CHEN
;
Huimin YI
;
Haijin LYU
Author Information
1. Surgical Intensive Care Unit, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
- Publication Type:Research Article
- Keywords:
Enhanced recovery after surgery;
Liver transplantation;
Decompensation of liver cirrhosis;
Model for end-stage liver disease;
Acute-on-chronic liver failure;
Hepatic encephalopathy;
Operation time
- From:
Organ Transplantation
2020;11(1):66-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the rationality and efficacy of enhanced recovery after surgery (ERAS) in liver transplant recipients. Methods Clinical data of 465 liver transplant recipients were retrospectively analyzed. All recipients were divided into the ERAS group (n=163) and control group (n=302) according to whether they received ERAS. The severity of disease in the ERAS group was worse than that in the control group. Operation situations including the operation time, anhepatic phase and intraoperative blood transfusion volume of the liver transplant recipients were observed and recorded. Postoperative recovery conditions including the length of intensive care unit (ICU) stay, total length of hospital stay, total ventilator removal time at postoperative 28 d and postoperative re-intubation rate were recorded. The survival rates at 90 d, 180 d and 1 year after liver transplantation were calculated. The influencing factors of survival rate of liver transplant recipients were analyzed. Results The anhepatic phase in the ERAS group was 45 (39, 53) min, significantly longer than 40 (32, 48) min in the control group (P < 0.05). The volume of erythrocyte infusion in the ERAS group was 10 (7, 13) U, significantly less than 18 (10, 28) U in the control group (P < 0.05). The length of postoperative ICU stay and total length of hospital stay in the ERAS group were 135 (84, 212) h and 24 (18, 33) d, significantly shorter than 154 (103, 253) h and 34 (20, 50) d in the control group (both P < 0.05). Total ventilator removal time at postoperative 28 d was 26 (25, 27) d, significantly longer than 26 (23, 27) d in the control group (P < 0.05). The postoperative re-intubation rate in the ERAS group was 11.0%, significantly lower than 20.8% in the control group (P < 0.05). The 90 d, 180 d and 1-year survival rates in the ERAS group were 92.8%, which were significantly higher than 81.1%, 78.1% and 75.7% in the control group (all P < 0.05). ERAS and operation time were the independent influencing factors of survival rate of liver transplant recipients (both P < 0.05). Conclusions ERAS after liver transplantation can improve the survival rate of recipient, shorten the length of hospital stay, reduce the re-intubation rate and accelerate the rehabilitation after liver transplantation.
