Continuous intraoperative arteriovenous hemodiafiltration in liver transplantation

This study reports two cases of urgent hepatic retransplantation due to graft failure developing 37 and 10 days after the first transplant in which intraoperative continuous arteriovenous hemodiafiltration (CAH) was performed. They were female patients aged 33 and 58 years respectively who presented...

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Published inRevista española de anestesiología y reanimación Vol. 38; no. 4; p. 271
Main Authors Pensado Castiñeiras, A, Gómez-Arnau, J, González Arévalo, A, Luengo Rodríguez, C, Domínguez Rico, E
Format Journal Article
LanguageSpanish
Published Spain 01.07.1991
Subjects
Acute Kidney Injury - etiology
Acute Kidney Injury - therapy
Adult
Blood Loss, Surgical
Extracorporeal Circulation - methods
Female
Graft Rejection
Hemofiltration
Humans
Intraoperative Care - methods
Liver Cirrhosis, Biliary - surgery
Liver Transplantation - adverse effects
Liver Transplantation - methods
Middle Aged
Renal Dialysis
Reoperation
Thrombosis - etiology
Water-Electrolyte Imbalance - etiology
Water-Electrolyte Imbalance - therapy
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Summary:This study reports two cases of urgent hepatic retransplantation due to graft failure developing 37 and 10 days after the first transplant in which intraoperative continuous arteriovenous hemodiafiltration (CAH) was performed. They were female patients aged 33 and 58 years respectively who presented oliguric renal insufficiency before surgery (plasmatic creatinine 2.6 and 2.8 mg/dl and urea 77 and 278 mg/dl) and severe electrolytic imbalance (sodium 128 and 135 mmol/l; potassium 8.5 and 3.8 mmol/l; bicarbonate 8.8 and 12.7 mmol/l; pH 7.18 and 7.16). In both cases CAH was used from the beginning of anesthetic induction (Hemofilter Biospal SCU/CAHH- Kit A2-U with reversed infusion of glucose Dianeal 1.5%). An intraoperative ultrafiltered volume of 2200 and 2400 ml was respectively obtained in each patient. The use of intraoperative CAH favoured the correction of the electrolyte imbalance, contributed to maintain the hemodynamic stability, and rendered the administration of fluids more appropriate during the surgical process.
ISSN:0034-9356