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13. Intraoperative Cardiac Arrests in Asian Recipients of Liver Transplantation—Second Report After Learning Curve.

Author

Choi, Jisun, Lee, SangHyun, Ko, Justin Sangwook, Gwak, Mi Sook, and Kim, Gaab Soo

Subjects
LEARNING curve, LIVER transplantation, CARDIAC arrest, SURVIVAL rate, HEART transplantation
Abstract

Background: Although surgical competency and anesthesia for liver transplantation (LT) have evolved significantly in the past decades, intraoperative cardiac arrest (ICA) is still an event that brings a poor prognosis to the recipient. We report a second‐decade experience of ICA as a follow‐up study of our first report at our institution. Methods: This is a retrospective observational study of the medical records and the Liver Transplant Program database of our institution. LT from January 2011 to June 2023 were included. Of the 1735 LT cases, a total of 1730 cases were included, excluding three non‐Asian and two simultaneous heart and liver transplants (1598 adult LT, 132 pediatric LT). Results: The ICA incidence during adult LT was 0.7% (11/1598) which is significantly lower compared to our first report (1.5%; 14/919) (p = 0.042). ICA occurred only in adult recipients. Post‐reperfusion syndrome (PRS, six cases) and bleeding (four cases) were the primary causes in most cases and most ICA occurred after reperfusion (10/11). The mortality rates within 24 h, 30 days, and 1 year were 27.3%, 45.5%, and 54.5%, respectively. The survival curve did not show a significant difference from our first report (p = 0.570), and the survival rate of the ICA group was significantly lower compared to the non‐ICA group. (p = 0.000) Conclusion: The incidence of ICA has decreased, but the main causes of ICA as PRS and bleeding after reperfusion have not changed. Additionally, there was no significant difference in the survival curves from the first report. Because ICA is still fatal, efforts to reduce its incidence should be continued. [ABSTRACT FROM AUTHOR]

Published
2024
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43. Bile duct anastomosis does not promote bacterial contamination of autologous blood salvaged during living donor liver transplantation

Author

Kim, Doyeon, primary, Han, Sangbin, additional, Kim, You Sang, additional, Choi, Gyu‐Sung, additional, Kim, Jong Man, additional, Lee, Kyo Won, additional, Ko, Jae‐Hoon, additional, Yoo, In Young, additional, Ko, Justin Sangwook, additional, Gwak, Mi Sook, additional, Joh, Jae‐Won, additional, and Kim, Gaab Soo, additional

Published
2022
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47. Liver transplantation in an adult patient with hepatocellular carcinoma following liver cirrhosis as a complication of the Fontan procedure -A case report

Author

Cho, Min-kyung, Kwon, Ji-Hye, Gwak, Mi Sook, Joh, Jae-Won, Hwang, JiYun, and Kim, Gaab Soo

Subjects
congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Cirrhosis, Hepatocellular carcinoma, medicine.medical_treatment, Case Report, Liver transplantation, Fontan procedure, 03 medical and health sciences, Liver disease, 0302 clinical medicine, medicine, 030212 general & internal medicine, business.industry, Central venous pressure, General Medicine, Transplantation Anesthesia, medicine.disease, Pulmonary edema, Surgery, surgical procedures, operative, Liver cirrhosis, 030211 gastroenterology & hepatology, Pulmonary atresia, business
Abstract

Background: Fontan-associated liver disease (FALD) is a hepatic disorder caused by hemodynamic changes and systemic venous congestion following the Fontan procedure. FALD includes liver cirrhosis and hepatocellular carcinoma (HCC), both of which may require liver transplantation (LT). However, the Fontan circulation, characterized by elevated central venous pressure and reduced cardiac output, is a challenging issue for surgeons and anesthesiologists.Case: We report a living-donor LT for the treatment of HCC. The patient was a 24-year-old male who underwent the Fontan procedure for pulmonary atresia and right ventricle hypoplasia. We focused on maintaining enough blood volume for cardiac output without causing pulmonary edema, as the patient is not well adapted to changes in volume. Owing to a multidisciplinary approach, the surgery was successfully performed without fatal adverse events.Conclusions: To our knowledge, this is the first case of isolated LT in a recipient who became an adult after having undergone the Fontan procedure.

Published
2020
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