End Stage Liver DIsease, Liver Cirrhosis, Liver Diseases, Liver Transplant; Complications
Conditions
Brief summary
The investigators attempted to evaluate whether the use of PAC is associated with better clinical outcomes after liver transplantation compared with the case without PAC.
Detailed description
Pulmonary artery catheter (PAC) has been used for advanced hemodynamic monitoring during liver transplantation. However, recent advances in less invasive monitoring could provide continuous cardiac output monitoring by arterial waveform analysis. Using this technology, stroke volume variation (SVV) is monitored as a preload index. Calculated systemic vascular resistance (SVR) can be monitored if central venous pressure (CVP) is provided. Therefore, this less invasive form of hemodynamic monitoring may replace the PAC. The investigators attempted to evaluate whether the use of PAC is associated with better clinical outcomes after liver transplantation compared with the case without PAC.
Interventions
DEVICEPulmonary artery catheter (Edward Lifesciences, Irvine, California, USA)
PAC was inserted and connected to a continuous cardiac output monitor (Vigilance I from 2006 to 2012; Vigilance II from 2012 to 2022, Edward Lifesciences, Irvine, USA)
DEVICEFloTrac Vigileo system (EV1000 clinical platform, Edward Lifesciences, Irvine, California, USA)
Without PAC, monitoring with FloTrac Vigileo system (EV1000 clinical platform, Edward Lifesciences, Irvine, California, USA) was performed for continuous cardiac output monitoring.
Sponsors
Seoul National University Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients who underwent living or deceased donor liver transplantation at our tertiary care university hospital between 2006 and 2022
Exclusion criteria
* Patients with baseline renal dysfunction * Missing baseline or outcome variables * Retransplantation * Patients who received intraoperative transesophageal echocardiography (TEE) monitoring
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants with acute kidney injury | the first 7 postoperative days | Acute kidney injury (AKI) was defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria, which was defined according to the greatest change in serum creatinine level during the postoperative seven days (Stage 1: more than 1.5-fold; stage 2: more than 2-fold; stage 3: more than 3-fold increase from baseline level or increase in serum creatinine to ≥ 4.0 mg/dL or the initiation of renal replacement therapy). The most recent serum creatinine level measured before surgery was collected as a baseline value. |
| Number of Participants with early allograft dysfunction | the first 7 postoperative days | Early allograft dysfunction (EAD) was defined when one or more of the following are present within the first 7 postoperative days: total bilirubin ≥ 10 mg/dL, prothrombin time: international normalized ratio ≥ 1.6, or aspartate or alanine transaminase \> 2000 IU/L |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| In-hospital mortality | the first month after admission | all-cause mortality during hospitalization |
| One-year mortality | one year after transplantation | all-cause mortality during one year after transplantation |
| Length of intensive care unit (ICU) stay | the first month after admission | Length of intensive care unit stay after transplantation |
| Length of hospital stay | the first month after admission | Length of hospital stay after transplantation |
Countries
South Korea
Contacts
Primary ContactJi-yoon Jung, MD
Outcome results
None listed