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Evaluation of the right ventricular ejection fraction during classic orthotopic liver transplantation without venovenous bypass
Author(s) -
Xu Haitao,
Li Weiwei,
Xu Zhendong,
Shi Xueyin
Publication year - 2012
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12010
Subject(s) - medicine , pulmonary artery catheter , hemodynamics , cardiology , liver transplantation , cardiac index , ejection fraction , stroke volume , artery , cardiac output , transplantation , anesthesia , heart failure
Background Right ventricular ( RV ) function is sensitive to changes in cardiac loading conditions, and RV dysfunction may contribute to hemodynamic instability during orthotopic liver transplantation ( OLT ). Thus, we evaluated RV function and its role in hemodynamic instability during classic OLT without venovenous bypass ( VVB ). Methods Thirty patients undergoing classic OLT without VVB were studied. Right ventricular ejection fraction ( RVEF ) was measured using a modified pulmonary artery catheter. Hemodynamic data were recorded at pre‐determined time points: T 0, baseline; T 1– T 3: 5, 15, and 30 min after clamping; T 4– T 7: 5, 15, 30, and 120 min after reperfusion; T 8 and T 9: 24 and 48 h after surgery. Results The baseline RVEF was lower than normal value. RVEF decreased significantly from T 1 to T 4 and returned to baseline beginning at T 5. At 24 and 48 h after surgery, RVEF was higher than baseline value. RVEF was correlated with stroke volume index and post‐reperfusion syndrome during OLT . Compared to the low MELD s group, RVEF in the high MELD s group was lower at T 1, T 2, and T 4. Conclusions Right ventricular function was compromised during the anhepatic and early reperfusion stages in patients undergoing classic OLT without VVB , particularly in the high MELD score patients. Close monitoring of RV function in these patients should be considered.