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

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...

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Autores principales: Larivière, Jordan, Giard, Jeanne-Marie, Zuo, Rui Min, Massicotte, Luc, Chassé, Michaël, Carrier, François Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270449/
https://www.ncbi.nlm.nih.gov/pubmed/34242370
http://dx.doi.org/10.1371/journal.pone.0254455
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author Larivière, Jordan
Giard, Jeanne-Marie
Zuo, Rui Min
Massicotte, Luc
Chassé, Michaël
Carrier, François Martin
author_facet Larivière, Jordan
Giard, Jeanne-Marie
Zuo, Rui Min
Massicotte, Luc
Chassé, Michaël
Carrier, François Martin
author_sort Larivière, Jordan
collection PubMed
description 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.
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spelling pubmed-82704492021-07-21 Association between intraoperative fluid balance, vasopressors and graft complications in liver transplantation: A cohort study Larivière, Jordan Giard, Jeanne-Marie Zuo, Rui Min Massicotte, Luc Chassé, Michaël Carrier, François Martin PLoS One Research Article 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. Public Library of Science 2021-07-09 /pmc/articles/PMC8270449/ /pubmed/34242370 http://dx.doi.org/10.1371/journal.pone.0254455 Text en © 2021 Larivière et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Larivière, Jordan
Giard, Jeanne-Marie
Zuo, Rui Min
Massicotte, Luc
Chassé, Michaël
Carrier, François Martin
Association between intraoperative fluid balance, vasopressors and graft complications in liver transplantation: A cohort study
title Association between intraoperative fluid balance, vasopressors and graft complications in liver transplantation: A cohort study
title_full Association between intraoperative fluid balance, vasopressors and graft complications in liver transplantation: A cohort study
title_fullStr Association between intraoperative fluid balance, vasopressors and graft complications in liver transplantation: A cohort study
title_full_unstemmed Association between intraoperative fluid balance, vasopressors and graft complications in liver transplantation: A cohort study
title_short Association between intraoperative fluid balance, vasopressors and graft complications in liver transplantation: A cohort study
title_sort association between intraoperative fluid balance, vasopressors and graft complications in liver transplantation: a cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270449/
https://www.ncbi.nlm.nih.gov/pubmed/34242370
http://dx.doi.org/10.1371/journal.pone.0254455
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