Individualized peri-operative fluid therapy facilitating early-phase recovery after liver transplantation

AIM: To investigate the correlation between peri-operative fluid therapy and early-phase recovery after liver transplantation (LT) by retrospectively reviewing 102 consecutive recipients. METHODS: Based on whether or not the patients had pulmonary complications, the patients were categorized into non-pulmonary and pulmonary groups. Twenty-eight peri-operative variables were analyzed in both groups to screen for the factors related to the occurrence of early pulmonary complications. RESULTS: The starting hemoglobin (Hb) value, an intra-operative transfusion > 100 mL/kg, and a fluid balance ≤ -14 mL/kg on the first day and the second or third day post-operatively were significant factors for early pulmonary complications. The extubation time, time to initial passage of flatus, or intensive care unit length of stay were significantly prolonged in patients who had not received an intra-operative transfusion ≤ 100 mL/kg or a fluid balance ≤ -14 mL/kg on the first day and the second or the third day post-operatively. Moreover, these patients had poorer results in arterial blood gas analysis. CONCLUSION: It is important to offer a precise and individualized fluid therapy during the peri-operative period to the patients undergoing LT for cirrhosis-associated hepatocellular carcinoma.