Strategies for Prevention of Post-reperfusion Syndrome in Orthotopic Liver Transplantation

Objective To investigate the preventive effect of comprehensive treatment and the use of vasoactive agents on post-reperfusion syndrome in patients undergoing orthotopic liver transplantation in order to avoiding post reperfusion syndrome.Methods 21 patients who received orthotopic liver transplantation were given comprehensive treatment(including fluid supplementation,anti-acidosis,warming and calcium supplement)and low-dose dopamine(2-10 μg·kg-1·min-1)and other vasoactive agents during the operation.The changes of mean artery pressure(MAP),heart rate(HR),central venous pressure(CVP),pulmonary artery pressure(PAP),body temperature,urinary output,blood gas analysis,blood sugar and electrolyte were recorded at different time-points during perioperative period.Results The hemodynamics of all patients was stable during the operation.Compared with the pre-anhepatic phase,MAP,PAP and CVP mildly decreased while HR mildly increased during the early anhepatic phase(within 5 minutes after the portal vein occlusion)and the early reperfusion phase(within 5 minutes after the portal vein reperfusion).MAP and HR returned to the baseline of the pre-anhepatic phase during the reperfusion phase. Blood gas analysis and electrolyte were normal.Although calcium decreased and blood sugar increased mildly during preoperative period,there was no need to manage it.There was no post-reperfusion syndrome occurred in the eight patients.Conclusion Comprehensive treatment and the use of vasoactive agents before the portal vein reperfusion in patients undergoing orthotopic liver transplantation may have preventive effects on post-reperfusion syndrome.