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Anesthetic complications including two cases of postoperative respiratory depression in living liver donor surgery

BACKGROUND: Living liver donation is becoming a more common means to treat patients with liver failure because of a shortage of cadaveric organs and tissues. There is a potential for morbidity and mortality, however, in patients who donate a portion of their liver. The purpose of this study is to id...

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Autores principales: Beebe, David, Singh, Harpreet, Jochman, John, Luikart, Paul, Gruessner, Ranier, Gruessner, Angelica, Belani, Kumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications Pvt Ltd 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3161463/
https://www.ncbi.nlm.nih.gov/pubmed/21897509
http://dx.doi.org/10.4103/0970-9185.83683
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author Beebe, David
Singh, Harpreet
Jochman, John
Luikart, Paul
Gruessner, Ranier
Gruessner, Angelica
Belani, Kumar
author_facet Beebe, David
Singh, Harpreet
Jochman, John
Luikart, Paul
Gruessner, Ranier
Gruessner, Angelica
Belani, Kumar
author_sort Beebe, David
collection PubMed
description BACKGROUND: Living liver donation is becoming a more common means to treat patients with liver failure because of a shortage of cadaveric organs and tissues. There is a potential for morbidity and mortality, however, in patients who donate a portion of their liver. The purpose of this study is to identify anesthetic complications and morbidity resulting from living liver donor surgery. PATIENTS AND METHODS: The anesthetic records of all patients who donated a segment of their liver between January 1997 and January 2006 at University of Minnesota Medical Center-Fairview were retrospectively reviewed. The surgical and anesthesia time, blood loss, hospitalization length, complications, morbidity, and mortality were recorded. Data were reported as absolute values, mean ± SD, or percentage. Significance (P < 0.05) was determined using Student's paired t tests. RESULTS: Seventy-four patients (34 male, 40 female, mean age = 35.5 ± 9.8 years) donated a portion of their liver and were reviewed in the study. Fifty-seven patients (77%) donated the right hepatic lobe, while 17 (23%) donated a left hepatic segment. The average surgical time for all patients was 7.8 ± 1.5 hours, the anesthesia time was 9.0 ± 1.3 hours, and the blood loss was 423 ± 253 ml. Forty-six patients (62.2%) received autologous blood either from a cell saver or at the end of surgery following acute, normovolemic hemodilution, but none required an allogenic transfusion. Two patients were admitted to the intensive care unit due to respiratory depression. Both patients donated their right hepatic lobe. One required reintubation in the recovery room and remained intubated overnight. The other was extubated but required observation in the intensive care unit for a low respiratory rate. Twelve patients (16.2%) had complaints of nausea, and two reported nausea with vomiting during their hospital stay. There were four patients who developed complications related to positioning during the surgery: Two patients complained of numbness and tingling in the hands which resolved within two days, one patient reported a blister on the hand, and one patient complained of right elbow pain that resolved quickly. Postoperative hospitalization averaged 7.4 ± 1.5 days. There was no patient mortality. DISCUSSION: Living liver donation can be performed with low morbidity. However, postoperative respiratory depression is a concern and is perhaps due to altered metabolism of administered narcotics and anesthetic agents.
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spelling pubmed-31614632011-09-06 Anesthetic complications including two cases of postoperative respiratory depression in living liver donor surgery Beebe, David Singh, Harpreet Jochman, John Luikart, Paul Gruessner, Ranier Gruessner, Angelica Belani, Kumar J Anaesthesiol Clin Pharmacol Original Article BACKGROUND: Living liver donation is becoming a more common means to treat patients with liver failure because of a shortage of cadaveric organs and tissues. There is a potential for morbidity and mortality, however, in patients who donate a portion of their liver. The purpose of this study is to identify anesthetic complications and morbidity resulting from living liver donor surgery. PATIENTS AND METHODS: The anesthetic records of all patients who donated a segment of their liver between January 1997 and January 2006 at University of Minnesota Medical Center-Fairview were retrospectively reviewed. The surgical and anesthesia time, blood loss, hospitalization length, complications, morbidity, and mortality were recorded. Data were reported as absolute values, mean ± SD, or percentage. Significance (P < 0.05) was determined using Student's paired t tests. RESULTS: Seventy-four patients (34 male, 40 female, mean age = 35.5 ± 9.8 years) donated a portion of their liver and were reviewed in the study. Fifty-seven patients (77%) donated the right hepatic lobe, while 17 (23%) donated a left hepatic segment. The average surgical time for all patients was 7.8 ± 1.5 hours, the anesthesia time was 9.0 ± 1.3 hours, and the blood loss was 423 ± 253 ml. Forty-six patients (62.2%) received autologous blood either from a cell saver or at the end of surgery following acute, normovolemic hemodilution, but none required an allogenic transfusion. Two patients were admitted to the intensive care unit due to respiratory depression. Both patients donated their right hepatic lobe. One required reintubation in the recovery room and remained intubated overnight. The other was extubated but required observation in the intensive care unit for a low respiratory rate. Twelve patients (16.2%) had complaints of nausea, and two reported nausea with vomiting during their hospital stay. There were four patients who developed complications related to positioning during the surgery: Two patients complained of numbness and tingling in the hands which resolved within two days, one patient reported a blister on the hand, and one patient complained of right elbow pain that resolved quickly. Postoperative hospitalization averaged 7.4 ± 1.5 days. There was no patient mortality. DISCUSSION: Living liver donation can be performed with low morbidity. However, postoperative respiratory depression is a concern and is perhaps due to altered metabolism of administered narcotics and anesthetic agents. Medknow Publications Pvt Ltd 2011 /pmc/articles/PMC3161463/ /pubmed/21897509 http://dx.doi.org/10.4103/0970-9185.83683 Text en © Journal of Anaesthesiology Clinical Pharmacology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Beebe, David
Singh, Harpreet
Jochman, John
Luikart, Paul
Gruessner, Ranier
Gruessner, Angelica
Belani, Kumar
Anesthetic complications including two cases of postoperative respiratory depression in living liver donor surgery
title Anesthetic complications including two cases of postoperative respiratory depression in living liver donor surgery
title_full Anesthetic complications including two cases of postoperative respiratory depression in living liver donor surgery
title_fullStr Anesthetic complications including two cases of postoperative respiratory depression in living liver donor surgery
title_full_unstemmed Anesthetic complications including two cases of postoperative respiratory depression in living liver donor surgery
title_short Anesthetic complications including two cases of postoperative respiratory depression in living liver donor surgery
title_sort anesthetic complications including two cases of postoperative respiratory depression in living liver donor surgery
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3161463/
https://www.ncbi.nlm.nih.gov/pubmed/21897509
http://dx.doi.org/10.4103/0970-9185.83683
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