Early Postoperative Complications of Liver Transplantation


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Abstract

IntroductionLiver transplantation operation is the only absolute therapy for end stage liver diseases. The postoperative severe complications may compromise patient survival. We aimed to evaluate the early postoperative complications of liver transplantation operations performed in our institution.MethodsThe medical records of the liver transplantation recipients during 2012 May - 2017 March period at Marmara University Hospital have been evaluated retrospectively. Postoperative surgical, heamodynamic, pulmonary and renal complications were recorded. Data were analyzed by descriptive statistics.ResultsTotally 35 patients (25% female, 75% male) were evaluated. The mean age was 44.6 ± 13,6 (10-64) years. Etiology of the recipient’s diseases mostly consisted of viral hepatitis, alcoholic and toxic hepatitis, malignancies and other etiological causes. Grafts from living donors were 35% (13 patients), while 65% (24 patients) were from cadaveric donors. Graft dysfunction occurred in 14% of the recipients. Pulmonary complication rate was 63%; pleural effusion, acute respiratory failure, atelectasis being the most frequent ones. Hemodynamic complication rate was 77%, the majority of which were hypertension, hypotension and tachycardia. Ten patients received renal replacement therapy. Renal complication rate was 40%. Complications due to surgery (bleeding, thrombosis) occurred in 28% of the patients. Two of the patients (6%) had re-transplantation due to primary graft dysfunction. Total mortality rate was 17%.ConclusionEarly postoperative complications especially the ones which may result in graft loss and reoperations may increase mortality after liver transplantation. Pulmonary and hemodynamic complications, in concordance with the literature consisted most of the complications we encountered [1][2]. A significant rate of mortality was determined during the early postoperative period of the liver transplantations done in our clinic. Patients who develop perioperative complications have higher mortality rate, thus prompt identification and appropriate management is needed if the outcomes are to be optimized.References:1. Feltracco P, Carollo C, Barbieri S, Pettenuzzo T, Ori C. Early respiratory complications after liver transplantation. World J Gastroenterol. 2013 Dec 28;19(48):9271-81.2. Zbroch E, Małyszko J, Myśliwiec M, Przybyłowski P, Durlik M. Hypertension in solid organ transplant recipients. Ann Transplant. 2012 Jan-Mar; 17(1):100-7.

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