Transplantation proceedings
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Comparative Study Observational Study
A Comparison of the Effects of Sevoflurane and Desflurane on Corrected QT Interval Prolongation in Patients Undergoing Living Donor Liver Transplantation: A Prospective Observational Study.
QT interval prolongation has frequently been observed in patients with advanced liver disease. We investigated the influence of inhalation anesthetics on the corrected QT (QTc) interval prolongation during surgery in patients undergoing living-donor liver transplantation. ⋯ In this prospective observational study, there was no significant difference in QTc intervals between sevoflurane and desflurane. QTc intervals increased during intubation and reperfusion relative to preoperative values in patients given either sevoflurane or desflurane.
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Comparative Study
Comparison of Postoperative Morphine Requirements in Renal Donors and Patients With Renal Carcinoma Undergoing Laparoscopic Nephrectomy.
The objective of this study was to evaluate postoperative pain intensity and morphine consumption between living renal donors and patients with renal cell carcinoma undergoing laparoscopic nephrectomy. ⋯ Living-renal donors suffer more pain and are associated with more morphine consumption than patients with cancer.
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Concerns about the adverse effects of hydroxyethyl starch (HES) on renal function have been raised in recent studies involving critically ill patients. We aimed to evaluate the effect of HES on acute kidney injury (AKI) after living donor right hepatectomy. ⋯ Intraoperative administration of HES may not be associated with AKI after living donor hepatectomy. This result can provide useful information on perioperative fluid management in living liver donors.
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There is increasing evidence that the occurrence of small-for-size syndrome (SFSS) depends on portal hemodynamics rather than graft size. The portal hyperperfusion has been regarded as the most important contributing factor to SFSS. However, it is unknown how much portal vein flow (PVF) or what limit of PVF the liver remnant can sustain in extreme hepatectomy. This study aimed to evaluate the limit of portal hyperperfusion in a stable porcine model. ⋯ The deaths of animals in the 85% group supports the hypothesis that the remnant vascular bed with 15% of liver volume represents a critical residual liver parenchyma in pigs, the safe minimum residual liver volume should be >15% of liver volume, indicating that the liver remnant can regenerate successfully in ∼5.6 times baseline of PVF, whereas it fails to regenerate in >5.6 times baseline of PVF.