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A multicenter evaluation of safety of early extubation in liver transplant recipients
Author(s) -
Mandell M. Susan,
Stoner Tamara J.,
Barnett Rebecca,
Shaked Abraham,
Bellamy Mark,
Biancofiore Gianni,
Niemann Claus,
Walia Ann,
Vater Youri,
Tran Zung V.,
Kam Igal
Publication year - 2007
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21263
Subject(s) - medicine , adverse effect , liver transplantation , perioperative , liver disease , model for end stage liver disease , intensive care medicine , multicenter study , transplantation , surgery , anesthesia , randomized controlled trial
Small single‐institutional studies performed prior to the introduction of organ allocation using the Model for End‐Stage Liver Disease (MELD) suggest that early airway extubation of liver transplant recipients is a safe practice. We designed a multicenter study to examine adverse events associated with early extubation in patients selected for liver transplantation using MELD score. A total of 7 institutions extubated all patients meeting study criteria and reported adverse events that occurred within 72 hours following surgery. Adverse events were uncommon: occurring in only 7.7% of 391 patients studied. Most adverse events were pulmonary or surgically related. Pulmonary complications were usually minor, requiring only an increase in ambient oxygen concentration. The majority of surgical adverse events required additional surgery. Analysis of a limited set of perioperative variables suggest that blood transfusions and technical factors were associated with an increased risk of adverse events. In conclusion, while early extubation appears to be safe under specified circumstances, there are performance differences between institutions that remain to be explained. Liver Transpl 13:1557–1563, 2007. © 2007 AASLD.