Publication: The impact of the analgesic agents administered in recipients of liver transplants on graft results
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Date
2022-01-01
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Abstract
Introduction and Objective
The ischemia-reperfusion injury that occurs in both
the donor and the recipient during liver
transplantation and the hemodynamic changes that
may occur in graft afterward significantly affect the
graft, sometimes triggering graft failure by causing
hepatocyte damage. It is known that inhalation
anesthetics provide ischemic preconditioning that
prevents ischemia-reperfusion injury, but their effect
on graft dysfunction caused by post-reperfusion
syndrome has not yet been clarified. Our study aimed
to reveal the effects of desflurane and sevoflurane
used during liver transplantation on graft survival.
Material and Method
This retrospective study was conducted following the
ethics committee approval (protocol no:
09.2021.1004/03.09.2021) and included 60 donors
and recipients of liver transplantation procedures
performed between 2015 and 2021. The patients were
divided into two groups depending on the agent
administered for anesthesia maintenance after
Anesth Crit Care 2022; 4 (1): 43-51 DOI: 10.26502/acc.037
Anesthesia and Critical Care 44
standard anesthesia induction: desflurane group
(Group 1, n=30) and sevoflurane group (Group 2,
n=30).
Recorded patient data included age, gender, body
mass index, smoking status, comorbidities, presence
of renal disease, total liver volume, graft volume,
remaining liver volume, total ischemic time, and
duration of anesthesia and surgery, graft survival,
hospital stay, diastolic blood pressure measured at the
beginning and the end of the procedure, systolic
blood pressure; and the values of aspartate
aminotransferase (AST), alanine aminotransferase
(ALT), international normalized ratio (INR),
albumin, total bilirubin, blood urea nitrogen,
creatinine, platelet count, and hemoglobin at the
postoperative 1, 7, and 30 days.
Results
Demographic data and length of hospital stay of the
recipients were similar (p>0.05). Intraoperative urine
output of the recipient patients in the desflurane
group (Group 1: 1909.52 1269.90, Group 2:
918.75618.14), ALT level at postoperative 7th day,
and total bilirubin value at the 6th month were found
to be significantly higher compared to the
sevoflurane group (p <0.01).
Discussion and Conclusion
Our study revealed that preconditioning with
sevoflurane during liver transplantation may have
greater positive effects on early hepatic and renal
functions as compared to desflurane. However, we
think that it is necessary tocarry out further
prospective randomized studies.
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Keywords
Sağlık Bilimleri, Health Sciences, Klinik Tıp (MED), Clinical Medicine (MED), Liver, Transplantation, Volatile agent, Ischemia-reperfusion
Citation
A S., Çabakli G T., Y K., Bilgili B., C Y., T U., "The Impact of the Analgesic Agents Administered in Recipients of Liver Transplants on Graft Results", Anesthesia and Critical Care, cilt.04, sa.01, ss.43-51, 2022