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Post-reperfusion syndrome during isolated intestinal transplantation: outcome and predictors
Authors:Siniscalchi Antonio  Cucchetti Alessandro  Miklosova Zuzana  Lauro Augusto  Zanoni Andrea  Spedicato Salvatore  Bernardi Enrico  Aurini Lucia  Pinna Antonio D  Faenza Stefano
Affiliation:Department of Anesthesiology, Alma Mater Studiorum, University of Bologna, Bologna, Italy. sinianest@libero.it
Abstract:
Siniscalchi A, Cucchetti A, Miklosova Z, Lauro A, Zanoni A, Spedicato S, Bernardi E, Aurini L, Pinna AD, Faenza S. Post‐reperfusion syndrome during isolated intestinal transplantation: outcome and predictors.
Clin Transplant 2011 DOI: 10.1111/j.1399‐0012.2011.01530.x
© 2011 John Wiley & Sons A/S. Abstract: Background: Post‐reperfusion syndrome (PRS) during isolated intestinal transplantation (ITx) is characterized by decreased systemic blood pressure, systemic vascular resistance, and cardiac output and by a moderate increased pulmonary arterial pressure. We hypothesize that the more severe PRS causes a poorer long‐term outcome. The primary aim of this study was to determine the independent clinical predictors of intra‐operative PRS, as well as to investigate the link between the severity of PRS and the intra‐operative profiles and to examine the post‐operative complications and their relationship with transplant outcome. Methods: This observational study was conducted on 27 patients undergoing isolated ITx in a single adult liver and multivisceral transplantation center. PRS was considered when the mean arterial blood pressure was 30% lower than the pre‐unclamping value and lasted for at least one min within 10 min after unclamping. Results and conclusions: The main results of this study can be summarized in two findings: in patients undergoing ITx, the duration of cold ischemia and the pre‐operative glomerular filtration rate were independent predictors of PRS and the occurrence of intra‐operative PRS was associated with significantly more frequent post‐operative renal failure and early post‐operative death.
Keywords:intestinal transplant  ischemia/reperfusion injury  post‐operative complication  post‐reperfusion syndrome
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