Key result
Intraoperative fluid restriction during living liver donor hepatectomy resulted in minimal estimated blood loss (91.3±78.9 mL) with no blood transfusions and no negative effect on renal function.
Why the study?
Does intraoperative fluid restriction reduce blood loss without impairing renal function in patients undergoing living liver donor hepatectomy?
Observational (n=167)
Does intraoperative fluid restriction reduce blood loss without impairing renal function in patients undergoing living liver donor hepatectomy?
Intraoperative fluid restriction in living liver donor hepatectomy effectively lowers CVP and minimizes blood loss without compromising postoperative renal function.
Fluid restriction may be feasible without renal harm in living liver donor hepatectomy; leaves open confirmation in prospective trials.
BACKGROUND The purpose of this study was to evaluate the effect and outcome of intraoperative fluid restriction in living liver donor hepatectomy, regarding changes in intraoperative CVP levels, blood loss, and postoperative renal function. MATERIAL AND METHODS The charts of 167 patients were reviewed and analyzed retrospectively. Intraoperative central venous pressure levels, blood loss, fluids infused, and urine output per hour, before and after the liver allograft procurement, were calculated. Perioperative renal functions were also analyzed. RESULTS Fluid infused before and after liver allograft procurement was 3.21±1.5 and 9.0±3.9 mL/Kg/h and urine output was 1.5±0.7 and 1.8±1.4 mL/Kg/h, respectively. Intraoperative estimated blood loss was 91.3±78.9 mL. No patients required blood transfusion. Their preoperative and postoperative hemoglobin were 12.3±2.7 and 11.7±1.7 g/dL. CVP levels decreased gradually from 10.4±3.0 to a low of 8.1±1.9 mmHg at the time of transection of the liver parenchyma. Renal functions were not significantly affected based on the determination of BUN and creatinine levels. CONCLUSIONS The methods used to lower CVP are moderate and slow, with 2 main goals achieved: minimal blood loss (91.3±78.9 ml) and no blood transfusion. Furthermore, it did not have any negative effect on renal function.
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Wang et al. (2017) conducted an observational in Living liver donor hepatectomy (n=167). Intraoperative fluid restriction was evaluated on Intraoperative CVP levels, blood loss, and postoperative renal function. Intraoperative fluid restriction during living liver donor hepatectomy resulted in minimal estimated blood loss (91.3±78.9 mL) with no blood transfusions and no negative effect on renal function.
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