Fast Tracking in Liver Transplantation: Which Patient Benefits From This Approach?

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Transplantation Proceedings

Volume

39, Issue 2 , March 2007, Pages 535-536

Fast Tracking in Liver

Transplantation: Which Patient Benefits From This Approach?

M. Glanemann,

R. Hoffmeister, U. Neumann, A. Spinelli,

J.M. Langrehr, U. Kaisers and P. Neuhaus

Department of General, Visceral, and Transplantation Surgery, Berlin,

Germany.

Abstract

In liver

transplantation, “fast tracking” means postoperative extubation in the operating theater immediately after

surgery. This procedure was performed in a series of

837 adult liver transplant recipients between January 1997 and April 2005,

proving to be safe and feasible in almost 80% of patients without increasing

the incidence of reintubation. This

patient population experienced a significantly higher survival compared to

patients who were extubated in the intensive care

unit. Consequently, fast tracking should become the

standard procedure after orthotopic liver

transplantation. However, special attention is

required for recipients with acute liver failure, retransplantation,

Child C status, or complicated surgery in terms of increased transfusion of red

blood cells. These patients do not participate in

fast-tracking protocols, as demonstrated by a uni-

and multivariate logistic regression analysis. Moreover,

ROC analysis revealed that only intraoperative

transfusion of ≤6 units of red blood cells was associated with extubation in the operating theater with highest

sensitivity (78.9%) and specifity (49.5%), area under

the ROC curve = 0.703 (standard error = 0.023; 95% confidence interval =

0.671–0.734).

Barb in Texas - Together in the Fight, Whatever it Takes!

Son Ken (32) UC 91 - PSC 99 Listed 7/21 @ Baylor Dallas

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Sign me up for the FAST TRACK!!!

Cindy Baudoux-Northrup

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What is "Child C status"? Do you know? AmiBarb Henshaw wrote: Transplantation Proceedings Volume 39, Issue 2 , March 2007, Pages 535-536 Fast Tracking in Liver Transplantation: Which Patient Benefits From This Approach? M. Glanemann, R. Hoffmeister, U. Neumann, A. Spinelli, J.M. Langrehr, U. Kaisers and P. Neuhaus Department of General, Visceral, and Transplantation Surgery, Berlin, Germany. Abstract In liver

transplantation, ¡°fast tracking¡± means postoperative extubation in the operating theater immediately after surgery. This procedure was performed in a series of 837 adult liver transplant recipients between January 1997 and April 2005, proving to be safe and feasible in almost 80% of patients without increasing the incidence of reintubation. This patient population experienced a significantly higher survival compared to patients who were extubated in the intensive care unit. Consequently, fast tracking should become the standard procedure after orthotopic liver transplantation. However, special attention is required for recipients with acute liver failure, retransplantation, Child C status, or complicated surgery in terms of increased transfusion

of red blood cells. These patients do not participate in fast-tracking protocols, as demonstrated by a uni- and multivariate logistic regression analysis. Moreover, ROC analysis revealed that only intraoperative transfusion of ¡Ü6 units of red blood cells was associated with extubation in the operating theater with highest sensitivity (78.9%) and specifity (49.5%), area under the ROC curve = 0.703 (standard error = 0.023; 95% confidence interval = 0.671¨C0.734). Barb in Texas - Together in the Fight, Whatever it Takes! Son Ken (32) UC 91 - PSC 99 Listed 7/21 @ Baylor Dallas Ami mom to - 9 yrs - Double Lung Tx 2/26/2006, PSC - Pre-Liver Tx, Central DI, Steroid Induced Diabetes, Hypothyroid, GERD, High BP, ADD, Anemia, Osteopenia, Gastroperesis, Varices mom to Emma - 13 yrs - Migraines stepmom to - 14 yrs -

ADHD, ODD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

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