Post-reperfusion syndrome during isolated intestinal transplantation: outcome and predictors

Clin Transplant. May-Jun 2012;26(3):454-60. doi: 10.1111/j.1399-0012.2011.01530.x. Epub 2011 Oct 17.

Abstract

Background: Post-reperfusion syndrome (PRS) during isolated intestinal transplantation (ITx) is characterized by decreased systemic blood pressure, systemic vascular resistance, and cardiac output and by a moderate increased pulmonary arterial pressure. We hypothesize that the more severe PRS causes a poorer long-term outcome. The primary aim of this study was to determine the independent clinical predictors of intra-operative PRS, as well as to investigate the link between the severity of PRS and the intra-operative profiles and to examine the post-operative complications and their relationship with transplant outcome.

Methods: This observational study was conducted on 27 patients undergoing isolated ITx in a single adult liver and multivisceral transplantation center. PRS was considered when the mean arterial blood pressure was 30% lower than the pre-unclamping value and lasted for at least one min within 10 min after unclamping.

Results and conclusions: The main results of this study can be summarized in two findings: in patients undergoing ITx, the duration of cold ischemia and the pre-operative glomerular filtration rate were independent predictors of PRS and the occurrence of intra-operative PRS was associated with significantly more frequent post-operative renal failure and early post-operative death.

MeSH terms

  • Adolescent
  • Adult
  • Cold Ischemia / mortality
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • Intestinal Diseases / mortality
  • Intestinal Diseases / surgery*
  • Intestines / surgery
  • Intestines / transplantation*
  • Male
  • Middle Aged
  • Organ Transplantation / adverse effects*
  • Organ Transplantation / mortality
  • Postoperative Complications*
  • Prognosis
  • Renal Insufficiency / etiology
  • Renal Insufficiency / mortality
  • Reperfusion Injury / etiology*
  • Reperfusion Injury / mortality*
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Syndrome
  • Young Adult