Enhanced recovery after liver transplantation—a prospective analysis focusing on quality assessment

作者：Xiaodong Yuan, Jiwei Qin, Hao Zheng, Can Qi, Yafei Guo, Zebin Zhu, Wei Wu, Zhijun Xu, Xuefeng Li, Ning Wang, Xiaoqing Chai, Yanhu Xie, Xiaogen Tao, Haihua Liu, Weiyong Liu, Guoyan Liu, Lei Ye, Kexue Deng, Yi Li, Xuebing Ji, Changlong Hou, Zhiqin Yao, Qiang Huang, Ruipeng Song, Shugeng Zhang, Jizhou Wang, Lianxin Liu, Björn Nashan · 发表于：HepatoBiliary Surgery and Nutrition · 年份：2024 · DOI：10.21037/hbsn-24-349 · 被引用次数：10 · 研究领域：Enhanced Recovery After Surgery、Organ Transplantation Techniques and Outcomes、Liver Disease and Transplantation

Background: Enhanced Recovery After Surgery (ERAS) is a multimodal approach for almost all types of surgical procedures, including liver transplantation (LTx). We developed an ERAS protocol for LTx based on previous experience and assessed it using benchmarks from the German Institute for Quality Management and Transparency in Healthcare (IQTIG). Methods: An ERAS protocol was developed and implemented in our center since 2018 for LTx, including preoperative, intraoperative, and postoperative procedures. From January 2021 to December 31st 2022, we conducted a prospective analysis including donor and recipient demographics, Model for End-Stage Liver Disease (MELD) score and medical history. Perioperative management, such as operative time, anhepatic phase time, intensive care unit (ICU) stay, morbidity and mortality as well as postoperative hospitalization, readmission and 1-year patient survival, were collected as outcome measures. Results: ), mean MELD score was 15 (range, 6-39), 3 patients had a MELD score higher than 30. Fifty-three patients suffered from hepatitis B virus (HBV) related cirrhosis. Twenty-eight patients had hepatocellular carcinoma (HCC); 5 patients were diagnosed with alcohol related cirrhosis and primary biliary cirrhosis, autoimmune disease and drug induced cirrhosis, undefined cirrhosis, respectively. The mean operation time in our cohort was 6.73 hours, and the average anhepatic phase time was 68 minutes. No patient had intraoperative hypothermia. Trach...