Brief Article
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World J Gastroenterol. Apr 28, 2012; 18(16): 1981-1986
Published online Apr 28, 2012. doi: 10.3748/wjg.v18.i16.1981
Individualized peri-operative fluid therapy facilitating early-phase recovery after liver transplantation
Guo-Qing Jiang, Ping Chen, Dou-Sheng Bai, Jing-Wang Tan, Hao Su, Min-Hao Peng
Guo-Qing Jiang, Ping Chen, Dou-Sheng Bai, Jing-Wang Tan, Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University, Yangzhou 225000, Jiangsu Province, China
Hao Su, Min-Hao Peng, Department of Hepatobiliary Surgery, First Affiliated Hospital, Guangxi Medial University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Author contributions: Jiang GQ and Chen P contributed equally to this work; Jiang GQ, Chen P, Bai DS and Peng MH designed the research; Jiang GQ, Bai DS and Chen P performed the research; Jiang GQ, Tan JW and Su H analyzed the data; Jiang GQ and Chen P wrote the paper.
Supported by Grants from the Bureau of Science and Technology of Guangxi Zhuang Autonomous Region, No. 0342014
Correspondence to: Min-Hao Peng, Professor, Department of Hepatobiliary Surgery, First Affiliated Hospital, Guangxi Medial University, Nanning 530021, Guangxi Zhuang Autonomous Region, China. minhaopeng@hotmail.com
Telephone: +86-771-5356799 Fax: +86-771-5356799
Received: August 28, 2011
Revised: December 22, 2011
Accepted: December 31, 2011
Published online: April 28, 2012
Abstract

AIM: To investigate the correlation between peri-operative fluid therapy and early-phase recovery after liver transplantation (LT) by retrospectively reviewing 102 consecutive recipients.

METHODS: Based on whether or not the patients had pulmonary complications, the patients were categorized into non-pulmonary and pulmonary groups. Twenty-eight peri-operative variables were analyzed in both groups to screen for the factors related to the occurrence of early pulmonary complications.

RESULTS: The starting hemoglobin (Hb) value, an intra-operative transfusion > 100 mL/kg, and a fluid balance ≤ -14 mL/kg on the first day and the second or third day post-operatively were significant factors for early pulmonary complications. The extubation time, time to initial passage of flatus, or intensive care unit length of stay were significantly prolonged in patients who had not received an intra-operative transfusion ≤ 100 mL/kg or a fluid balance ≤ -14 mL/kg on the first day and the second or the third day post-operatively. Moreover, these patients had poorer results in arterial blood gas analysis.

CONCLUSION: It is important to offer a precise and individualized fluid therapy during the peri-operative period to the patients undergoing LT for cirrhosis-associated hepatocellular carcinoma.

Keywords: Fluid therapy; Liver transplantation; Early-phase recovery; Pulmonary complications; Hemoglobin