Epinephrine and Phenylephrine Pretreatments for Preventing Postreperfusion Syndrome During Adult Liver Transplantation.
Ryu HG, Jung CW, et al.Liver Transplantation 2012 [record in progress].
Aims
To assess whether epinephrine and phenylephrine pre-treatments would prevent post-reperfusion syndrome (PRS).
Interventions
Intravenous infusion of bolus of 10 mcg of epinephrine versus 100 mcg of phenylephrine versus intravenous infusion of normal saline at the time of graft reperfusion.
Participants
96 adult liver transplant recipients.
Outcomes
Occurrence of PRS, use of vasoactive drugs, postoperative ICU and hospital stays and in-hospital mortality. Perioperative laboratory parameters included hemoglobin, serum albumin, serum total bilirubin and serum aminotransferases. Factors predicting the occurrence of PRS included in the regression models were patient characteristics (age, gender, body mass index, model for end-stage liver disease score, diagnosis, history of diabetes mellitus, preoperative use of propranolol, prolonged QT interval and diastolic dysfunction in the echocardiography), surgery-related factors (anesthesia time, typ
Follow-up
30 days postoperative
CET Conclusions
In this carefully designed double blind, randomised trial to study the attenuation of post reperfusion syndrome (PRS) in a liver transplant, patients received epinephrine, phenylephrine or normal saline (control group) at the time of graft reperfusion. It appeared that pre-treatment with 10mcg of epinephrine or 100mcg of phenylephrine significantly reduced the occurrence of PRS and vasopressor requirements with no adverse effects in adults after liver transplantation.
Data analysis
Modified intention-to-treat analysis
Trial registration
NCT 01080625 (ClinicalTrials.gov)