Enhanced recovery after surgery is feasible and safe in liver transplantation: a cohort study.

Autor:	Hillingsø JG; Department of Surgery and Transplantation, Centre of Cancer and Organ Dysfunction, Rigshospitalet, Copenhagen University Hospital, University of Copenhagen, Denmark. Electronic address: jens.hillingsoe@regionh.dk., Rostved AA; Department of Surgery and Transplantation, Centre of Cancer and Organ Dysfunction, Rigshospitalet, Copenhagen University Hospital, University of Copenhagen, Denmark., Dengsø KE; Department of Surgery and Transplantation, Centre of Cancer and Organ Dysfunction, Rigshospitalet, Copenhagen University Hospital, University of Copenhagen, Denmark., Sørensen CL; Department of Surgery and Transplantation, Centre of Cancer and Organ Dysfunction, Rigshospitalet, Copenhagen University Hospital, University of Copenhagen, Denmark., Frederiksen HJ; Department of Anesthesia, Centre for Cancer and Organ Dysfunction, Rigshospitalet, Copenhagen University Hospital, University of Copenhagen, Denmark., Krohn PS; Department of Surgery and Transplantation, Centre of Cancer and Organ Dysfunction, Rigshospitalet, Copenhagen University Hospital, University of Copenhagen, Denmark., Petersen CR; Department of Surgery and Transplantation, Centre of Cancer and Organ Dysfunction, Rigshospitalet, Copenhagen University Hospital, University of Copenhagen, Denmark., Larsen PN; Department of Surgery and Transplantation, Centre of Cancer and Organ Dysfunction, Rigshospitalet, Copenhagen University Hospital, University of Copenhagen, Denmark., Fukumori D; Department of Surgery and Transplantation, Centre of Cancer and Organ Dysfunction, Rigshospitalet, Copenhagen University Hospital, University of Copenhagen, Denmark., Burgdorff SK; Department of Surgery and Transplantation, Centre of Cancer and Organ Dysfunction, Rigshospitalet, Copenhagen University Hospital, University of Copenhagen, Denmark., Kehlet H; Section for Surgical Pathophysiology, Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Denmark., Schultz NA; Department of Surgery and Transplantation, Centre of Cancer and Organ Dysfunction, Rigshospitalet, Copenhagen University Hospital, University of Copenhagen, Denmark.
Jazyk:	angličtina
Zdroj:	HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2022 Nov; Vol. 24 (11), pp. 2022-2028. Date of Electronic Publication: 2022 Jul 20.
DOI:	10.1016/j.hpb.2022.07.010
Abstrakt:	Background: The principles of enhanced recovery after surgery (ERAS) are being applied to still more advanced procedures. Liver transplantation offers a unique opportunity for a multimodal approach including donor care as well. Our objective was to determine if ERAS was applicable and safe in orthotopic liver transplantation (OLT). Methods: A national single centre retrospective study showing the implementation of ERAS from 2013 to 2019 with the proceeding 2 years serving as baseline. The primary endpoints were mortality, length of stay (LOS) in the ward and intensive care unit stay. Secondary endpoints were complications estimated by Dindo-Clavien classification, comprehensive complication index (CCI®) and re-admissions. Results: A total of 334 patients were included. LOS was significantly reduced from a median of 22.5 days at introduction to 14 days at 2019. Cold ischaemia time was reduced from a mean of 10.7 to 6.0 h and the use of blood products (erythrocytes, plasma and thrombocytes) from a median of 28 to 6 units. Complications were reduced in severity. Mortality and readmission rates were not affected. Conclusion: ERAS principles are safe and recommended in patients undergoing OLT resulting in reduced severity of complications and LOS without affecting re-admissions or mortality. (Copyright © 2022 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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