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12 March 2019 : Original article  

The Incidence and Risk Factors of Low Oxygenation After Orthotropic Liver Transplantation

Mingli Zhu1ABEG, Jiemin Wang1BCDE, Qiaoling Wang2B, Kewei Xie2B, Minzhou Wang2B, Cheng Qian2B, Yuxiao Deng1DF, Longzhi Han3DF, Yuan Gao1DF, Zhaohui Ni2EF, Qiang Xia3EF, Leyi Gu2ACDEG*

DOI: 10.12659/AOT.913716

Ann Transplant 2019; 24:139-146


BACKGROUND: This study was designed to observe incidence and risk factors of low oxygenation after orthotropic liver transplantation (OLT).

MATERIAL AND METHODS: We retrospectively evaluated all adult patients who underwent living-donor OLT between January 1, 2017 and December 31, 2017. Postoperative low oxygenation was defined as PaO₂/FiO₂ <300 mmHg within 24 hours after surgery. Early acute kidney injury (AKI) after OLT was also defined when AKI was happened with 24 hours after operative.

RESULTS: A total of 301 patients, aged 50.35±10.29 years were enrolled. Of these patients, 100 patients (33.2%) suffered postoperative low oxygenation (PaO₂/FiO₂=251.80±35.84). Compared with the normal oxygenation group, body mass index (BMI) (24.48±3.53 versus 23.1±3.27 kg/m², P=0.001), preoperative hemoglobin (115.79±29.27 versus 111.52±29.80 g/L, P=0.033), preoperative MELD (22.25±6.54 versus 20.24±5.74, P=0.008), and intraoperative urinary volume (1.25 [0.76, 1.89] versus 2.04 [1.49, 3.68] mL/kg/h, P=0.003) were higher in low oxygenation group. There were more cases of earlier AKIs that occurred after OLT in low oxygenation patients than that in normal group (47% versus 23.4%, P<0.001). Logistic analysis showed that the preoperative BMI (hazard ration [HR]=1.107, [1.010, 1.212], P=0.029) and early AKI after OLT (HR=2.115, [1.161, 3.855], P=0.014) were independent risk factors for postoperative low oxygenation.

CONCLUSIONS: The incidence of postoperative low oxygenation after liver transplantation in adults was 33.2%. BMI and early AKI after OLT were correlated with postoperative hypoxemia.

Keywords: Acute Kidney Injury, acute lung injury, Liver Transplantation, End stage liver disease, hypoxia, Incidence, Middle Aged, Postoperative Complications, Retrospective Studies, Risk Factors

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358