TY - JOUR
T1 - Intracranial pressure during liver transplantation for fulminant hepatic failure
AU - Detry, Olivier
AU - Arkadopoulos, Nikolaos
AU - Ting, Paul
AU - Kahaku, Elaine
AU - Margulies, Jody
AU - Arnaout, Walid
AU - Colquhoun, Steven D.
AU - Rozga, Jacek
AU - Demetriou, Achilles A.
PY - 1999/3/15
Y1 - 1999/3/15
N2 - During orthotopic liver transplantation (OLT) for fulminant hepatic failure (FHF), some patients develop cerebral injury secondary to intracranial hypertension. We monitored intracranial pressure (ICP) and cerebral perfusion pressure (CPP) before and during OLT in 12 FHF patients undergoing transplantation. All four patients who had normal ICP preoperatively maintained normal ICP/CPP throughout OLT. During OLT, four of the eight patients with pretransplant intracranial hypertension had six episodes of ICP increase. These episodes of intracranial hypertension occurred during failing liver dissection (n=3) and graft reperfusion (n=3). At the end of the anhepatic phase, the ICP was lower than the preoperative ICP in all patients, and was below 15 mmHg in all but one patient. These data suggest that in FHF patients who develop intracranial hypertension before OLT, dissection of the native liver and graft reperfusion are associated with a risk of brain injury resulting from intracranial hypertension and cerebral hypoperfusion.
AB - During orthotopic liver transplantation (OLT) for fulminant hepatic failure (FHF), some patients develop cerebral injury secondary to intracranial hypertension. We monitored intracranial pressure (ICP) and cerebral perfusion pressure (CPP) before and during OLT in 12 FHF patients undergoing transplantation. All four patients who had normal ICP preoperatively maintained normal ICP/CPP throughout OLT. During OLT, four of the eight patients with pretransplant intracranial hypertension had six episodes of ICP increase. These episodes of intracranial hypertension occurred during failing liver dissection (n=3) and graft reperfusion (n=3). At the end of the anhepatic phase, the ICP was lower than the preoperative ICP in all patients, and was below 15 mmHg in all but one patient. These data suggest that in FHF patients who develop intracranial hypertension before OLT, dissection of the native liver and graft reperfusion are associated with a risk of brain injury resulting from intracranial hypertension and cerebral hypoperfusion.
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U2 - 10.1097/00007890-199903150-00024
DO - 10.1097/00007890-199903150-00024
M3 - Article
C2 - 10096539
AN - SCOPUS:0033559063
SN - 0041-1337
VL - 67
SP - 767
EP - 770
JO - Transplantation
JF - Transplantation
IS - 5
ER -