ArticleFrontiers in medicine2016
Refractory Hypotension after Liver Allograft Reperfusion: A Case of Dynamic Left Ventricular Outflow Tract Obstruction.
Article in Frontiers in medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 20 citations in OpenAlex.
- Systolic anterior motion of mitral chordae tendineae: prevalence and clinical implications in liver transplantation.Anesthesia and pain medicine · 2020Article
- Cardiac output measurement in liver transplantation patients using pulmonary and transpulmonary thermodilution: a comparative study.Journal of clinical monitoring and computing · 2019Observational
- Transesophageal echocardiography in orthotopic liver transplantation: a comprehensive intraoperative monitoring tool.Critical ultrasound journal · 2017Review
- Utility of transesophageal echocardiography during orthotopic liver transplantation: A narrative review.Annals of cardiac anaesthesiaReview
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Authors and funding
6 authors at 1 institution in 1 country.
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Abstract
Hypotension after reperfusion is a common occurrence during liver transplantation following the systemic release of cold, hyperkalemic, and acidic contents of the liver allograft. Moreover, the release of vasoactive metabolites such as inflammatory cytokines and free radicals from the liver and mesentery, compounded by the hepatic uptake of blood, may also cause a decrement in systemic perfusion pressures. Thus, the postreperfusion syndrome (PRS) can materialize if hypotension and fibrinolysis occur concomitantly within 5 min of reperfusion. Treatment of the PRS may require the administration of inotropes, vasopressors, and intravenous fluids to maintain hemodynamic stability. However, the occurrence of the PRS and its treatment with inotropes and calcium chloride may lead to dynamic left ventricular outflow tract obstruction (DLVOTO) precipitating refractory hypotension. Expedient diagnosis of DLVOTO with transesophageal echocardiography is extremely vital in order to avoid potential cardiovascular collapse during this critical period.
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