Effect of "the Awakening Protocol" in the outcome of liver transplantation
PURPOSE: To analyze mortality (7 days) or graft loss in liver transplantation (Tx) performed within the Awakening Protocol (AP) compared to sequential Tx. METHODS: Analysis of 243 liver tx (230 patients), divided into sequential tx or PD (early morning) to compare graft loss or death (7 days). Significant differences at p <0.05 RESULTS: The PD was adopted in 32.5% of tx. The cold ischemia time (p <0.01) and the interval until transplantation (p <0.01) were significantly different. Age of the donor and recipient, Donor Risk Index, MELD score, and donor base excess, sodium, creatinine and glucose were not different between groups. Previous abdominal surgery was a risk factor for early mortality, but was equally distributed between the groups. There was no difference in mortality or graft loss within 7 days (p = 0.521) CONCLUSION: The adoption of PD, to start tx the morning when harvesting occurs after 10p.m. did not result in worse patient and graft survival. Transplant patients with fulminant hepatic failure and high-risk grafts do not apply to this surgical tactics.
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Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia
2013
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oai:scielo:S0102-865020130013000142013-02-01Effect of "the Awakening Protocol" in the outcome of liver transplantationLima,Agnaldo SoaresAmado,Leandro Ricardo de NavarroDuarte,Malvina Maria de FreitasSanches,Marcelo DiasResende,Alexandre Prado deZocrato,João Ricardo MirandaZocrato,Maria Eva Costa Liver transplantation Surgical procedures Operative Organ transplantation Liver transplantation Method PURPOSE: To analyze mortality (7 days) or graft loss in liver transplantation (Tx) performed within the Awakening Protocol (AP) compared to sequential Tx. METHODS: Analysis of 243 liver tx (230 patients), divided into sequential tx or PD (early morning) to compare graft loss or death (7 days). Significant differences at p <0.05 RESULTS: The PD was adopted in 32.5% of tx. The cold ischemia time (p <0.01) and the interval until transplantation (p <0.01) were significantly different. Age of the donor and recipient, Donor Risk Index, MELD score, and donor base excess, sodium, creatinine and glucose were not different between groups. Previous abdominal surgery was a risk factor for early mortality, but was equally distributed between the groups. There was no difference in mortality or graft loss within 7 days (p = 0.521) CONCLUSION: The adoption of PD, to start tx the morning when harvesting occurs after 10p.m. did not result in worse patient and graft survival. Transplant patients with fulminant hepatic failure and high-risk grafts do not apply to this surgical tactics.info:eu-repo/semantics/openAccessSociedade Brasileira para o Desenvolvimento da Pesquisa em CirurgiaActa Cirúrgica Brasileira v.28 suppl.1 20132013-01-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-86502013001300014en10.1590/S0102-86502013001300014 |
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Lima,Agnaldo Soares Amado,Leandro Ricardo de Navarro Duarte,Malvina Maria de Freitas Sanches,Marcelo Dias Resende,Alexandre Prado de Zocrato,João Ricardo Miranda Zocrato,Maria Eva Costa |
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Lima,Agnaldo Soares Amado,Leandro Ricardo de Navarro Duarte,Malvina Maria de Freitas Sanches,Marcelo Dias Resende,Alexandre Prado de Zocrato,João Ricardo Miranda Zocrato,Maria Eva Costa Effect of "the Awakening Protocol" in the outcome of liver transplantation |
author_facet |
Lima,Agnaldo Soares Amado,Leandro Ricardo de Navarro Duarte,Malvina Maria de Freitas Sanches,Marcelo Dias Resende,Alexandre Prado de Zocrato,João Ricardo Miranda Zocrato,Maria Eva Costa |
author_sort |
Lima,Agnaldo Soares |
title |
Effect of "the Awakening Protocol" in the outcome of liver transplantation |
title_short |
Effect of "the Awakening Protocol" in the outcome of liver transplantation |
title_full |
Effect of "the Awakening Protocol" in the outcome of liver transplantation |
title_fullStr |
Effect of "the Awakening Protocol" in the outcome of liver transplantation |
title_full_unstemmed |
Effect of "the Awakening Protocol" in the outcome of liver transplantation |
title_sort |
effect of "the awakening protocol" in the outcome of liver transplantation |
description |
PURPOSE: To analyze mortality (7 days) or graft loss in liver transplantation (Tx) performed within the Awakening Protocol (AP) compared to sequential Tx. METHODS: Analysis of 243 liver tx (230 patients), divided into sequential tx or PD (early morning) to compare graft loss or death (7 days). Significant differences at p <0.05 RESULTS: The PD was adopted in 32.5% of tx. The cold ischemia time (p <0.01) and the interval until transplantation (p <0.01) were significantly different. Age of the donor and recipient, Donor Risk Index, MELD score, and donor base excess, sodium, creatinine and glucose were not different between groups. Previous abdominal surgery was a risk factor for early mortality, but was equally distributed between the groups. There was no difference in mortality or graft loss within 7 days (p = 0.521) CONCLUSION: The adoption of PD, to start tx the morning when harvesting occurs after 10p.m. did not result in worse patient and graft survival. Transplant patients with fulminant hepatic failure and high-risk grafts do not apply to this surgical tactics. |
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Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia |
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2013 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-86502013001300014 |
work_keys_str_mv |
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