背景和目的:评估脉搏指数连续心输出量和MostCare压力记录分析方法血流动力学监测系统对成年患者活体肝移植过程中短期移植物和患者预后的影响。材料和方法:总体而言,在2018年1月至2022年3月期间接受活体肝移植并符合研究纳入标准的163例成年患者,根据手术期间使用的血流动力学监测系统分为两组:MostCare压力记录分析方法组(n=73)和脉搏指数连续心输出量组(n=90)。比较两组的术前临床人口学特征(年龄,性别,身体质量指数,移植物与受体的体重比,和终末期肝病评分模型),术中临床特征,和术后生化参数(天冬氨酸转氨酶,丙氨酸氨基转移酶,总胆红素,直接胆红素,凝血酶原时间,国际标准化比率,和血小板计数)。结果:就接受者年龄而言,组间没有显着差异,性别,身体质量指数,移植物与受体的体重比,孩子,终末期肝病评分模型,射血分数,肺动脉收缩压,手术时间,无肝期,冷缺血时间,热缺血时间,红细胞悬浮液使用,人白蛋白的使用,晶体的使用,尿量,住院,和重症监护病房。然而,新鲜冰冻血浆使用(p<0.001)和血小板使用(p=0.037)有显著差异.结论:脉搏指数连续心输出量与MostCare压力记录分析方法作为活体肝移植的血流动力学监测系统之间的临床和生化结果没有显着差异。然而,mostcare压力记录分析方法是更经济和微创。
Background and Objectives: To evaluate the effects of the pulse index continuous cardiac output and MostCare Pressure Recording Analytical Method hemodynamic monitoring systems on short-term graft and patient outcomes during living donor liver transplantation in adult patients. Materials and Methods: Overall, 163 adult patients who underwent living donor liver transplantation between January 2018 and March 2022 and met the study inclusion criteria were divided into two groups based on the hemodynamic monitoring systems used during surgery: the MostCare Pressure Recording Analytical Method group (n = 73) and the pulse index continuous cardiac output group (n = 90). The groups were compared with respect to preoperative clinicodemographic features (age, sex, body mass index, graft-to-recipient weight ratio, and Model for End-stage Liver Disease score), intraoperative clinical characteristics, and postoperative biochemical parameters (aspartate aminotransferase, alanine aminotransferase, total bilirubin, direct bilirubin, prothrombin time, international normalized ratio, and platelet count). Results: There were no significant between-group differences with respect to recipient age, sex, body mass index, graft-to-recipient weight ratio, Child, Model for End-stage Liver Disease score, ejection fraction, systolic pulmonary artery pressure, surgery time, anhepatic phase, cold ischemia time, warm ischemia time, erythrocyte suspension use, human albumin use, crystalloid use, urine output, hospital stay, and intensive care unit stay. However, there was a significant difference in fresh frozen plasma use (p < 0.001) and platelet use (p = 0.037). Conclusions: The clinical and biochemical outcomes are not significantly different between pulse index continuous cardiac output and MostCare Pressure Recording Analytical Method as hemodynamic monitoring systems in living donor liver transplantation. However, the MostCare Pressure Recording Analytical Method is more economical and minimally invasive.