Association between intraoperative fluid balance, vasopressors and graft complications in liver transplantation: A cohort study.

Bibliographic Details
Title: Association between intraoperative fluid balance, vasopressors and graft complications in liver transplantation: A cohort study.
Authors: Larivière, Jordan1 (AUTHOR), Giard, Jeanne-Marie2 (AUTHOR), Zuo, Rui Min3 (AUTHOR), Massicotte, Luc4 (AUTHOR), Chassé, Michaël5 (AUTHOR), Carrier, François Martin3,5,6 (AUTHOR) francois.martin.carrier@umontreal.ca
Source: PLoS ONE. 7/9/2021, Vol. 15 Issue 7, p1-16. 16p.
Subject Terms: *WATER-electrolyte balance (Physiology), *LIVER transplantation, *VASOCONSTRICTORS, *COHORT analysis, *GRAFT survival, *URETHRA stricture
Abstract: Introduction: Biliary complications following liver transplantation are common. The effect of intraoperative fluid balance and vasopressors on these complications is unknown. Materials and methods: We conducted a cohort study between July 2008 and December 2017. Our exposure variables were the total intraoperative fluid balance and the use of vasopressors on ICU admission. Our primary outcome was any biliary complication (anastomotic and non-anastomotic strictures) up to one year after transplantation. Our secondary outcomes were vascular complications, primary graft non-function and survival. Results: We included 562 consecutive liver transplantations. 192 (34%) transplants had a biliary complication, 167 (30%) had an anastomotic stricture and 56 had a non-anastomotic stricture (10%). We did not observe any effect of intraoperative fluid balance or vasopressor on biliary complications (HR = 0.97; 95% CI, 0.93 to 1.02). A higher intraoperative fluid balance was associated with an increased risk of primary graft non-function (non-linear) and a lower survival (HR = 1.40, 95% CI, 1.14 to 1.71) in multivariable analyses. Conclusion: Intraoperative fluid balance and vasopressors upon ICU admission were not associated with biliary complications after liver transplantation but may be associated with other adverse events. Intraoperative hemodynamic management must be prospectively studied to further assess their impact on liver recipients' outcomes. [ABSTRACT FROM AUTHOR]
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Database: Academic Search Complete
More Details
ISSN:19326203
DOI:10.1371/journal.pone.0254455
Published in:PLoS ONE
Language:English