Efficacy and safety of heat exchanger added to venovenous bypass circuit during orthotopic liver transplantation

G. Neelakanta, Steven D Colquhoun, M. Csete, D. Koroleff, A. Mahajan, R. W. Busuttil

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Hypothermia during orthotopic liver transplantation (OLT) is common despite measures to prevent this complication. We retrospectively analyzed two groups of patients; those managed with (n = 113) or without (n = 109) a heat exchanger (HE) incorporated in the venovenous bypass (VVB) circuit to test the hypothesis that normothermia before liver reperfusion minimizes hypotension during reperfusion and decreases neohepatic transfusion requirements. Use of the HE resulted in significantly warmer patients during reperfusion and at the end of surgery (P < .001). An increase in neohepatic transfusion requirement was observed in patients with HE use: packed red- blood cells, 4 ± 4 versus 3 ± 3 units; fresh-frozen plasma, 5 ± 5 versus 4 ± 4 units; platelets, 8 ± 8 versus 6 ± 7 units; and cryoprecipitate, 5 ± 7 versus 3 ± 5 units. There was no difference between the two groups in the untoward hemodynamic events during reperfusion of the liver (P = .31). We conclude that during OLT, the use of an HE in a nonheparinized VVB circuit helps maintain normothermia. Our limited experience suggests that its use is safe but does not improve hemodynamic stability during reperfusion or decrease blood loss during the neohepatic period.

Original languageEnglish (US)
Pages (from-to)506-509
Number of pages4
JournalLiver Transplantation and Surgery
Volume4
Issue number6
DOIs
StatePublished - Jan 1 1998
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Hepatology

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