Intracranial pressure during liver transplantation for fulminant hepatic failure

Olivier Detry, Nikolaos Arkadopoulos, Paul Ting, Elaine Kahaku, Jody Margulies, Walid Arnaout, Steven D Colquhoun, Jacek Rozga, Achilles A. Demetriou

Research output: Contribution to journalArticlepeer-review

56 Scopus citations


During orthotopic liver transplantation (OLT) for fulminant hepatic failure (FHF), some patients develop cerebral injury secondary to intracranial hypertension. We monitored intracranial pressure (ICP) and cerebral perfusion pressure (CPP) before and during OLT in 12 FHF patients undergoing transplantation. All four patients who had normal ICP preoperatively maintained normal ICP/CPP throughout OLT. During OLT, four of the eight patients with pretransplant intracranial hypertension had six episodes of ICP increase. These episodes of intracranial hypertension occurred during failing liver dissection (n=3) and graft reperfusion (n=3). At the end of the anhepatic phase, the ICP was lower than the preoperative ICP in all patients, and was below 15 mmHg in all but one patient. These data suggest that in FHF patients who develop intracranial hypertension before OLT, dissection of the native liver and graft reperfusion are associated with a risk of brain injury resulting from intracranial hypertension and cerebral hypoperfusion.

Original languageEnglish (US)
Pages (from-to)767-770
Number of pages4
Issue number5
StatePublished - Mar 15 1999
Externally publishedYes

ASJC Scopus subject areas

  • Transplantation
  • Immunology


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