Impact of late-night liver transplantation on recipient outcome - Archive ouverte HAL
Article Dans Une Revue Updates in Surgery Année : 2024

Impact of late-night liver transplantation on recipient outcome

Résumé

When liver graft procurements take place in the late afternoon or in the evening, transplantation is often performed at night when alertness and psychomotor abilities may be altered. Our objective was to determine whether liver transplantation performed at night increases severe 90-day postoperative complication rates. In this observational study, we analyzed all consecutive patients who were transplanted between January 1, 2012 and December 31, 2018. Outcomes were compared according to whether all or part of the liver transplantation was performed or not (control group) at late night, i.e., between midnight and 5 a.m. The main outcome was rate of Clavien-Dindo ≥ IIIb complications within 90 days post-transplantation. 790 liver transplantations were analyzed. In a multivariable analysis adjusted for cold ischemic time, late-night procedures required more blood transfusions (P = 0.010) and had higher odds of severe complication occurrence than controls (odds ratio 1.67; 95% CI, [1.10-2.54]). One-year graft and patient survival was similar. We conclude that the organization of liver transplant surgery should be reconsidered to avoid LN surgery as much as can be done. Except to create teams dedicated to night work (which represents a considerable cost), such organization may require safe extension of liver graft preservation times. The alternative could be to extend the use of oxygenated machine perfusion preservation with the unique purpose of safely extending the graft preservation time.
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mercredi 9 avril 2025
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hal-04765894 , version 1 (28-11-2024)

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Isis Carton, Estelle Le Pabic, Alexandre Thobie, Heithem Jeddou, Fabien Robin, et al.. Impact of late-night liver transplantation on recipient outcome. Updates in Surgery, 2024, 76 (7), pp.2635-2643. ⟨10.1007/s13304-024-01991-4⟩. ⟨hal-04765894⟩
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