Korean J Anesthesiol.
2016 Feb;69(1):37-43. 10.4097/kjae.2016.69.1.37.
Arrhythmogenic potential develops rapidly at graft reperfusion before the start of hypotension during living-donor liver transplantation
- Affiliations
-
- 1Department of Anesthesiology and Pain Medicine, Laboratory for Cardiovascular Dynamics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. kshwang@amc.seoul.kr
- 2Department of Anesthesiology and Pain Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
- 3Department of Anesthesiology and Pain Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea.
- KMID: 2152858
- DOI: http://doi.org/10.4097/kjae.2016.69.1.37
Abstract
- BACKGROUND
Detailed profiles of acute hypothermia and electrocardiographic (ECG) manifestations of arrhythmogenicity were examined to analyze acute hypothermia and ventricular arrhythmogenic potential immediately after portal vein unclamping (PVU) in living-donor liver transplantation (LT).
METHODS
We retrospectively analyzed electronically archived medical records (n = 148) of beat-to-beat ECG, arterial pressure waveforms, and blood temperature (BT) from Swan-Ganz catheters in patients undergoing living-donor LT. The ECG data analyzed were selected from the start of BT drop to the initiation of systolic hypotension after PVU.
RESULTS
On reperfusion, acute hypothermia of < 34degrees C, < 33degrees C and < 32degrees C developed in 75.0%, 37.2% and 11.5% of patients, respectively. BT decreased from 35.0degrees C +/- 0.8degrees C to 33.3degrees C +/- 1.0degrees C (range 35.8degrees C-30.5degrees C). The median time to nadir of BT was 10 s after PVU. Difference in BT (DeltaBT) was weakly correlated with graft-recipient weight ratio (GRWR; r = 0.22, P = 0.008). Compared to baseline, arrhythmogenicity indices such as corrected QT (QTc), Tp-e (T wave peak to end) interval, and Tp-e/QTc ratio were prolonged (P < 0.001 each). ST height decreased and T amplitude increased (P < 0.001 each). However, no correlation was found between DeltaBT and arrhythmogenic indices.
CONCLUSIONS
In living-donor LT, regardless of extent of BT drop, ventricular arrhythmogenic potential developed immediately after PVU prior to occurrence of systolic hypotension.
MeSH Terms
Cited by 1 articles
-
Cardiovascular dysfunction and liver transplantation
Hye-Mee Kwon, Gyu-Sam Hwang
Korean J Anesthesiol. 2018;71(2):85-91. doi: 10.4097/kjae.2018.71.2.85.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Left at right heterotopic implantation of left liver graft in adult-to-adult living donor liver transplantation: the technical concern for decision-making
- Effects of portal hyperperfusion on partial liver grafts in the presence of hyperdynamic splanchnic circulation: hepatic regeneration versus portal hyperperfusion injury
- Anatomical limits in living donor liver transplantation
- Liver retransplantation for adult recipients
- Minimal-incision donor right hepatectomy for living donor liver transplantation
