RESUMO
ABSTRACT Background : Cold ischemia time is related to success of liver transplantation. Aim : To compare the impact of cold ischemia time on allografts locally collected to those collected distantly. Methods : Were evaluated 83 transplantations. The patients were divided in two groups: those who received liver grafts collected from cities out of Curitiba (n=42) and locally (n=41). From the donors were compared: cause of death, days at ICU, cardiac arrest, vasoactive drugs, lab exams, gender, age, and BMI. Were compared the subsequent information of receptors: cold ischemia time, warm ischemia time, length of surgery, lab exams, etiology of cirrhosis, MELD score, age, gender, histology of graft, use of vasoactive drugs, and blood components transfusion. Were evaluated the correlation between cold ischemia time and lab results. Results : The liver grafts collected from other cities were submitted to a longer cold ischemia time (500±145 min) compared to those locally collected (317,85±105 min). Donors from other cities showed a higher serum sodium level at donation (154±16 mEq/dl) compared to those from Curitiba (144±10 mEq/dl). The length of cold ischemia time was related to serum levels of ALT and total bilirubin. Conclusion : Liver grafts distantly collected underwent longer cold ischemia times, although it caused neither histologic injuries nor higher transfusion demands. There is a correlation between cold ischemia time and hepatic injury, translated by elevation of serum ALT and total bilirubin levels.
RESUMO Racional : O tempo de isquemia fria está relacionado ao sucesso do transplante hepático. Objetivo : Comparar o impacto do tempo dela sobre enxertos captados localmente com os distantes. Métodos : Avaliaram-se 83 transplantes. Os pacientes foram divididos em dois grupos: enxertos captados fora de Curitiba (n=42) e captados localmente (n=41). Dos doadores compararam-se causa do óbito, dias de UTI, parada cardíaca, drogas vasoativas, exames laboratoriais, gênero, idade e IMC. Dos receptores seguintes dados: tempos de isquemia fria e morna, tempo operatório, exames laboratoriais, causa da cirrose, MELD, idade na operação, gênero, biópsia do enxerto, uso de drogas vasoativas e necessidade de transfusões. Foi realizada avaliação de correlação entre o tempo de isquemia fria e os exames laboratoriais. Resultados : Os enxertos captados à distância foram submetidos a maior tempo de isquemia fria (500,3±145 min) quando comparados aos captados localmente (317,85±105 min). Os doadores de fora apresentaram níveis mais elevados de sódio no momento da doação (154±16 mEq/dl) comparados aos doadores de Curitiba (144±10 mEq/dl). Houve correlação entre o tempo de isquemia fria e os níveis de ALT e de bilirrubina total. Não houve diferenças ao comparar-se os demais dados. Conclusão : Enxertos captados à distância sofreram maior tempo de isquemia fria. Isso não refletiu nos prejuízos histológicos nem na demanda transfusional durante o pós-operatório. Houve correlação entre o tempo de isquemia fria e o grau de lesão hepática avaliada pela ALT e pela bilirrubina total.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Transplante de Fígado/métodos , Isquemia Fria , Fígado/fisiologia , Fatores de Tempo , Estudos Retrospectivos , Recuperação de Função Fisiológica , Aloenxertos/fisiologiaRESUMO
BACKGROUND: Cold ischemia time is related to success of liver transplantation. AIM: To compare the impact of cold ischemia time on allografts locally collected to those collected distantly. METHODS: Were evaluated 83 transplantations. The patients were divided in two groups: those who received liver grafts collected from cities out of Curitiba (n=42) and locally (n=41). From the donors were compared: cause of death, days at ICU, cardiac arrest, vasoactive drugs, lab exams, gender, age, and BMI. Were compared the subsequent information of receptors: cold ischemia time, warm ischemia time, length of surgery, lab exams, etiology of cirrhosis, MELD score, age, gender, histology of graft, use of vasoactive drugs, and blood components transfusion. Were evaluated the correlation between cold ischemia time and lab results. RESULTS: The liver grafts collected from other cities were submitted to a longer cold ischemia time (500±145 min) compared to those locally collected (317,85±105 min). Donors from other cities showed a higher serum sodium level at donation (154±16 mEq/dl) compared to those from Curitiba (144±10 mEq/dl). The length of cold ischemia time was related to serum levels of ALT and total bilirubin. CONCLUSION: Liver grafts distantly collected underwent longer cold ischemia times, although it caused neither histologic injuries nor higher transfusion demands. There is a correlation between cold ischemia time and hepatic injury, translated by elevation of serum ALT and total bilirubin levels.
