Korean J Transplant.  2022 Nov;36(Supple 1):S256. 10.4285/ATW2022.F-4009.

Early complication of liver transplantation in the intensive care unit

• Sumiya S
• Magsar S
• Badmaanyambuu M
• Bayarsaikhan E

• KMID: 2535473
• DOI: http://doi.org/10.4285/ATW2022.F-4009

Abstract

Background
Early complications usually happen during the 1st month and complication during the stay at the intensive care unit has important impact on the further survival of the patient. Early complications include postoperative bleeding, coagulopathy, graft dysfunction, vascular thrombosis, rejection, infection (complication of respiratory), renal dysfunction, gastrointestinal, and neurological complication. In the long term, the complications are typically a consequence of the prolonged immunosuppressive therapy, and include diabetes mellitus, systemic arterial hypertension, de novo neoplasia, and organ toxicities, particularly nephrotoxicity.
Methods
Clinical data of 60 adult patients who received liver transplantation in National Cancer Center of Mongolia from 2018 to 2022.
Results
The study included 60 patients who were performed liver transplantation. Of whom 28 (46.7%) were male and 32 (53.3%) were female. Fifty cases (83.3%) on living donor liver transplant, 10 cases (16.7%) are deceased liver transplant. Of 60 liver trans-plantations, one patient (1.7%) developed early hepatic artery thrombosis, seven patients (11.7%) had acute kidney injury, one patient (1.7%) had cardiomyopathy, three patients (5.0%) had delirium, one patient (1.7%) had postoperative bleeding, one patient (1.7%) had hypoxia, one patient (1.7%) had multiple infections, and one patient (1.7%) had hypertension.
Conclusions
Intensive care management of liver transplanted patients requires sophisticated monitoring and multidisciplinary approach. Rapid hemodynamic stabilization, correction of severe coagulopathy, respiratory stabilization and early weaning from mechanical ventilation, appropriate fluid-electrolyte therapy, preservation of renal functions, prevention of graft rejection, and prophylaxis/treatment of infection are particularly important in intensive care management of liver transplanted patients. Since early postoperative period is critical, close monitoring, stabilization and maintenance of cardiorespiratory functions, frequent examination of graft function, early identification of complications, and prompt treatment of extrahepatic organ failure are mandatory in order to reduce mortality/morbidity.