Evaluation of Mechanical Ventilation and Its Influencing Factors between the Living Related Liver Transplantation and Cadaveric Whole Liver Transplantation

Lee, Jae Min; Chang, Hae Wone; Park, Chul Soo; Park, Hue Jung; Kim, Jeong Eun; Choi, Jong Ho

Abstract

BACKGROUND: Postoperative pulmonary complications are amongst the greatest causes of morbidity and mortality during liver transplantation. Postoperative mechanical ventilation and tracheal extubation are important parts of postoperative critical care. However, there are no comparative studies on postoperative mechanical ventilation, duration of intensive care units admission between cadaveric whole liver transplantation and living related liver transplantation groups, which are different from anesthetic and surgical procedures. In our present study, we have compared mechanical ventilation, duration of ICU admission and its influencing factors between the two groups.
METHODS
We have retrospectively studied 67 cases and depending on the surgical procedures, we divided them into two groups; control group undergoing cadaveric whole liver transplantation and experimental group undergoing living related liver transplantation. Each group was evaluated based on operation time, time of mechanical ventilation, duration of ICU admission, amounts of infused fluid and transfusion during operation, preoperative and extubation O2 index, serum creatinine levels, and preoperative and intraoperative risk score.
RESULTS
The mechanical ventilation time in experimental group was observed to be shorter than in control group, and serum creatinine level during the 3rd postoperative day in experimental group was lower than in control group (P<0.05). However, there was no difference in duration of ICU admission, O2 index, fluid amount and transfusion, and risk score between the two groups.
CONCLUSIONS
We conclude that living related liver transplantation reduces mechanical ventilation time with no effect on ICU admission periods. Higher risk score is correlated with prolongation of postoperative mechanical ventilation.