Incidence, Outcomes, and Risk Factors of Intraoperative Cardiac Arrest During Orthotopic Liver Transplantation

Incidence, Outcomes, and Risk Factors of Intraoperative Cardiac Arrest During Orthotopic Liver Transplantation

•Intraoperative cardiac arrest (ICA) during liver transplantation (LT) is associated with elevated perioperative and in-hospital mortality rates.•Patients who experienced ICA during LT and received effective treatment demonstrated satisfactory long-term survival outcomes.•The identified risk factors...

Full description

Saved in:
Bibliographic Details
Published in:Transplantation proceedings Vol. 56; no. 3; pp. 608 - 612
Main Authors: Tovikkai, Parichat, Suphathamwit, Aphichat, Raksakietisak, Manee, Tovikkai, Chutwichai, Siriussawakul, Arunotai, Sujirattanawimol, Kittiphong, Piriyapatsom, Annop, Pongraweewan, Orawan, Tankul, Rattanaporn, Hemtanon, Nattachai, Boonyakarn, Sutatta, Noinonthong, Chularat, Rattanaruangrit, Chumsab, Soontarinka, Suvit
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-04-2024
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:•Intraoperative cardiac arrest (ICA) during liver transplantation (LT) is associated with elevated perioperative and in-hospital mortality rates.•Patients who experienced ICA during LT and received effective treatment demonstrated satisfactory long-term survival outcomes.•The identified risk factors for ICA during LT include hypothermia and hyperkalemia. Intraoperative cardiac arrest (ICA) during liver transplantation (LT) is a rare surgical complication that results in devastating outcomes. Moreover, previous worldwide studies have found inconsistencies in the risk factors associated with ICA in LT. This was a retrospective cohort study of adult patients who underwent LT between January and October 2021 at Siriraj Hospital, a tertiary care hospital. The incidence of ICA and outcomes of patients who experienced ICA were examined. Risk factors associated with ICA were investigated as a secondary objective. Among 342 patients, the incidence of ICA was 3.5% (95% CI 1.8%-6.1%). Of these, 33.3% died intraoperatively. Among patients with ICA, 41.7% died within 30 days, compared with only 7.6% in those without ICA (P = .002). Moreover, the in-hospital mortality rate of those with ICA was 58.3%, which was significantly higher than that of those without ICA (9.7%, P < .001). However, 41.7% of patients with ICA were discharged alive with long-term survival. Because ICA is a rare event, we found only 2 independent factors significantly associated with ICA. These factors include intraoperative temperature below 35°C, with an odds ratio (OR) of 6.07 (95% CI:1.32-27.88, P = .02) and elevated intraoperative serum potassium, with an OR of 4.57 (95% CI:2.15-9.67, P < .001). ICA is associated with high perioperative and in-hospital mortality. However, our findings suggest that with effective management of ICA, more than 40% of these patients could be discharged with excellent long-term outcomes. Hypothermia and hyperkalemia were independent risk factors significantly associated with ICA.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2024.01.029