Effect of perioperative terlipressin infusion on systemic, hepatic, and renal hemodynamics during living donor liver transplantation.
Fayed N, Refaat EK, et al.Journal of Critical Care 2013; pii: S0883-9441(13)00060-9
Aims
To evaluate the effect of intraoperative and postoperative terlipressin infusion compared with conventional vasopressors on systemic, hepatic and renal hemodynamics during adult living donor liver transplantation.
Interventions
The experimental group received terlipressin infusion at the beginning of surgery at a dose of 3µgkg¯¹h¯¹ with a rate titrated to maintain a mean arterial pressure (MAP) greater than 65mmHg and systemic vascular resistance less than 1300 dyne s¯¹ cm¯âµ. The dose was reduced to 1.5 µgkg¯¹h¯¹ after reperfusion and continued until the third postoperative day.
Participants
80 adult patients scheduled for living donor liver transplantation.
Outcomes
The outcomes for this study included systemic hemodynamics, hepatic and renal arterial resistive indices and portal venous blood flow.
Follow-up
5 postoperative days.
CET Conclusions
80 recipients were randomly allocated at the time of surgery to either receive terlipressin at the beginning of surgery and during the first 3 postoperative days, or not (the control group ). There was a significant decrease in hepatic arterial resistance and in renal artery resistance and also in the portal venous blood flow in the terlipressin group. Thus this study suggests that the use of a terlipressin infusion in this way might reduce the need for intraoperative vasoactive support and hence improve post-operative renal function.
Data analysis
Per protocol analysis
Trial registration
Not reported.