Open AccessIntraoperative High Fraction of Inspiratory Oxygen is Independently Associated with Worse Outcome After Living‐Donor Liver Transplantation: A Retrospective Study
Author(s) -
Miyachi Yosuke,
Kaido Toshimi,
Hirata Masaaki,
Sharshar Mohamed,
Macshut Mahmoud,
Yao Siyuan,
Kamo Naoko,
Kai Shinichi,
Yagi Shintaro,
Uemoto Shinji
Publication year - 2022
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-022-06544-7
Subject(s) - medicine , abdominal surgery , cardiac surgery , vascular surgery , cardiothoracic surgery , living donor liver transplantation , retrospective cohort study , transplantation , liver transplantation , surgery
Background Ischemia and reperfusion injury is an important factor that determines graft function after liver transplantation, and oxygen plays a crucial role in this process. However, the relationship between the intraoperative high fraction of inspiratory oxygen (FiO 2 ) and living‐donor‐liver‐transplantation (LDLT) outcome remains unclear. Patients and Methods A total of 199 primary adult‐to‐adult LDLT cases in Kyoto University Hospital between January 2010 and December 2017 were enrolled in this study. The intraoperative FiO 2 was averaged using the total amount of intraoperative oxygen and air and defined as the calculated FiO 2 (cFiO 2 ). The cutoff value of cFiO 2 was set at 0.5. Results Between the cFiO 2 <0.5 ( n = 156) and ≥0.5 group ( n = 43), preoperative recipients’ background, donor factors, and intraoperative parameters were almost comparable. Postoperatively, the cFiO 2 ≥0.5 group showed a higher early allograft dysfunction (EAD) rate ( P = 0.049) and worse overall graft survival ( P = 0.036) than the cFiO 2 <0.5 group. Although the cFiO 2 ≥0.5 was not an independent risk factor for EAD in multivariable analysis (OR 2.038, 95%CI 0.992–4.186, P = 0.053), it was an independent risk factor for overall graft survival after LDLT (HR 1.897, 95%CI 1.007–3.432, P = 0.048). Conclusion The results of this study suggest that intraoperative high FiO 2 may be associated with worse graft survival after LDLT. Avoiding higher intraoperative FiO 2 may be beneficial for LDLT recipients.