INITIAL OUTCOMES OF LIVER TRANSPLANTATION USING CLASSIC TECHNIQUE WITH VENA CAVA RECONSTRUCTION AT VIETDUC UNIVERSITY HOSPITAL
Main Article Content
Abstract
Objectives:To evaluate the efficacy and safety of the modified classic liver transplantation technique, focusing on optimized clamp release sequence, in patients undergoing liver transplantation at VietDuc University Hospital. Methods: A retrospective study was conducted on 17 patients undergoing liver transplantation from October 2024 to April 2025 at VietDuc University Hospital. Parameters were evaluated, including clinical and laboratory characteristics, operative time, blood loss, blood transfusion, early post-operative outcomes, and 90-day mortality rate. Results: The mean operative time was 366.5 ± 59.9 minutes, warm ischemia time was 24.8 ± 5.0 minutes, and median blood loss was 1,200mL. Medical complications (infections) occurred in 29.4%, 17.6% had post-reperfusion syndrome. The 90-day mortality rate was 11.8% (2 cases), with no instances of acute rejection or delayed graft function recorded. Conclusion: The modified classic liver transplantation demonstrates feasibility, with short warm ischemia time, reduced blood loss, and acceptable complication rates. Further studies with larger sample sizes and longer follow-up periods are needed to assess long-term efficacy.
Keywords
Liver transplantation, Modified classical liver transplant, Warm ischemia time, Short-term outcome
Article Details
References
2. He XS, Ma Y, Wu LW, Ju WQ, Wu JL, Hu RD, Chen GH, & Huang JF. Safe time to warm ischemia and posttransplant survival of liver graft from non-heart-beating donors. World J Gastroenterol. 2004; 10(21): 3157-3160. https://doi.org/10.3748/wjg.v10.i21.3157.
3. Kitajima T, Nagai S, Al-Kurd A, Delvecchio K, Yeddula S, Rizzari M, Yoshida A, Abouljoud M & Collins K. Short recipient warm ischemia time improves graft survival in deceased donor liver transplantation: 20-year experience of liver transplantation. Transplantation. 2020; 104(S3). https://journals.lww.com/transplantjournal/fulltext/2020/09003/short_recipient_warm_ischemia_time_improves_graft.35.aspx.
4. Fonouni H, Mehrabi A, Soleimani M, Müller SA, Büchler MW & Schmidt J. The need for venovenous bypass in liver transplantation. HPB: The Official Journal of the International Hepato Pancreato Biliary Association. 2008; 10(3):196-203. https://doi.org/10.1080/ 13651820801953031.
5. Manning MW, Kumar PA, Maheshwari K & Arora H. Post-reperfusion syndrome in liver transplantation—an overview. Journal of Cardiothoracic and Vascular Anesthesia. 2020; 34(2):501-511. https://doi.org/10.1053/j.jvca.2019.02.050.
6. Nakasuji M & Bookallil MJ. Pathophysiological mechanisms of postrevascularization hyperkalemia in orthotopic liver transplantation. Anesth Analg. 2000; 91(6):1351-1355. https://doi.org/10.1097/00000539-2000 12000-00008.
7. Zarrinpar A, Lee C, Noguchi E, Yersiz H, Agopian VG, Kaldas FM, Farmer DG & Busuttil RW. A rapid, reproducible, noninvasive predictor of liver graft survival. J Surg Res. 2015; 197(1):183-190.https://doi.org/10.1016/ j.jss.2015.03.093.
8. Al-Kurd A, Kitajima T, Delvecchio K, Tayseer Shamaa M, Ivanics T, Yeddula S, Yoshida A, Rizzari M, Collins K, Abouljoud M & Nagai S. Short recipient warm ischemia time improves outcomes in deceased donor liver transplantation. Transpl Int. 2021; 34(8):1422-1432.https://doi.org/10.111 1/tri.13962