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World Journal of Surgery

Published in:

01-08-2010

Effects of Low Central Venous Pressure During Preanhepatic Phase on Blood Loss and Liver and Renal Function in Liver Transplantation

Authors: Zhi-Ying Feng, Xiao Xu, Sheng-Mei Zhu, Berthold Bein, Shu-Sen Zheng

Published in: World Journal of Surgery | Issue 8/2010

Abstract

Background

Although the low central venous pressure (LCVP) technique is used to decrease blood loss during liver resection, its efficacy and safety during transplant procedures are still debatable. Our study aimed to assess the effects of this technique and its clinical safety for recipients undergoing liver transplantation.

Methods

Eighty-six adult patients were randomly divided into a LCVP group and a control group. In the LCVP group, CVP was maintained below 5 mmHg or 40% lower than baseline during the preanhepatic phase by limiting infusion volume, manipulating the patient’s posture, and administration of somatostatin and nitroglycerine. Recipients in the control group received standard care. Hemodynamics, blood loss, liver function, and renal function of the two groups were compared perioperatively.

Results

A lower CVP was maintained in the LCVP group during the preanhepatic phase, resulting in a significant decrease in blood loss (1922 ± 1429 vs. 3111 ± 1833 ml, P < 0.05) and transfusion volume (1200 ± 800 vs. 2400 ± 1200 ml, P < 0.05) intraoperatively. Compared with the control group, the LCVP group had a significantly lower mean arterial pressure at 2 h after the start of the operation (74 ± 11 vs. 84 ± 14 mmHg, P < 0.05), a lower lactate value at the end of the operation (5.9 ± 3.0 vs. 7.2 ± 3.0 mmol/l, P < 0.05), and a better preservation of liver function after the declamping of the portal vein. There were no significant differences in perioperative renal function and postoperative complications between the groups.

Conclusions

The LCVP technique during the preanhepatic phase reduced intraoperative blood loss, protected liver function, and had no detrimental effects on renal function in LT.

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Title: Effects of Low Central Venous Pressure During Preanhepatic Phase on Blood Loss and Liver and Renal Function in Liver Transplantation
Authors: Zhi-Ying Feng
Xiao Xu
Sheng-Mei Zhu
Berthold Bein
Shu-Sen Zheng
Publication date: 01-08-2010
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 8/2010
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-010-0544-y

At a glance: The STEP trials

Springer Medicine

Effects of Low Central Venous Pressure During Preanhepatic Phase on Blood Loss and Liver and Renal Function in Liver Transplantation

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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