Conditioning With Sevoflurane in Liver Transplantation: Results of a Multicenter Randomized Controlled Trial

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorBECK-SCHIMMER, Beatrice
dc.contributor.authorBONVINI, John M.
dc.contributor.authorSCHADDE, Erik
dc.contributor.authorDUTKOWSKI, Philipp
dc.contributor.authorOBERKOFLER, Christian E.
dc.contributor.authorLESURTEL, Mickael
dc.contributor.authorDEOLIVEIRA, Michelle L.
dc.contributor.authorFIGUEIRA, Estela R. R.
dc.contributor.authorROCHA FILHO, Joel A.
dc.contributor.authorAULER JR., Jose Otavio Costa
dc.contributor.authorD'ALBUQUERQUE, Luiz A. C.
dc.contributor.authorREYNTJENS, Koen
dc.contributor.authorWOUTERS, Patrick
dc.contributor.authorROGIERS, Xavier
dc.contributor.authorDEBAERDEMAEKER, Luc
dc.contributor.authorGANTER, Michael T.
dc.contributor.authorWEBER, Achim
dc.contributor.authorPUHAN, Milo A.
dc.contributor.authorCLAVIEN, Pierre-Alain
dc.contributor.authorBREITENSTEIN, Stefan
dc.date.accessioned2016-03-14T14:21:14Z
dc.date.available2016-03-14T14:21:14Z
dc.date.issued2015
dc.description.abstractBackground. During times of organ scarcity and extended use of liver grafts, protective strategies in transplantation are gaining importance. We demonstrated in the past that volatile anesthetics such as sevoflurane attenuate ischemia-reperfusion injury during liver resection. In this randomized study, we examined if volatile anesthetics have an effect on acute graft injury and clinical outcomes after liver transplantation. Methods. Cadaveric liver transplant recipients were enrolled from January 2009 to September 2012 at 3 University Centers (Zurich/Sao Paulo/Ghent). Recipients were randomly assigned to propofol (control group) or sevoflurane anesthesia. Postoperative peak of aspartate transaminase was defined as primary endpoint, secondary endpoints were early allograft dysfunction, in-hospital complications, intensive care unit, and hospital stay. Results. Ninety-eight recipients were randomized to propofol (n = 48) or sevoflurane (n = 50). Median peak aspartate transaminase after transplantation was 925 (interquartile range, 512-3274) in the propofol and 1097 (interquartile range, 540-2633) in the sevoflurane group. In the propofol arm, 11 patients (23%) experienced early allograft dysfunction, 7 (14%) in the sevoflurane one (odds ratio, 0.64 (0.20 to 2.02, P = 0.45). There were 4 mortalities (8.3%) in the propofol and 2 (4.0%) in the sevoflurane group. Overall and major complication rates were not different. An effect on clinical outcomes was observed favoring the sevoflurane group (less severe complications), but without significance. Conclusions. This first multicenter trial comparing propofol with sevoflurane anesthesia in liver transplantation shows no difference in biochemical markers of acute organ injury and clinical outcomes between the 2 regimens. Sevoflurane has no significant added beneficial effect on ischemia-reperfusion injury compared to propofol.
dc.description.indexMEDLINE
dc.identifier.citationTRANSPLANTATION, v.99, n.8, p.1606-1612, 2015
dc.identifier.doi10.1097/TP.0000000000000644
dc.identifier.eissn1534-6080
dc.identifier.issn0041-1337
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/13367
dc.language.isoeng
dc.publisherLIPPINCOTT WILLIAMS & WILKINS
dc.relation.ispartofTransplantation
dc.rightsrestrictedAccess
dc.rights.holderCopyright LIPPINCOTT WILLIAMS & WILKINS
dc.subject.other100 consecutive patients
dc.subject.otherright hepatectomy
dc.subject.otherrenal-functions
dc.subject.othersurgery
dc.subject.otherdesflurane
dc.subject.otheranesthesia
dc.subject.otherresection
dc.subject.otherpreservation
dc.subject.otherquality
dc.subject.othergrafts
dc.subject.wosImmunology
dc.subject.wosSurgery
dc.subject.wosTransplantation
dc.titleConditioning With Sevoflurane in Liver Transplantation: Results of a Multicenter Randomized Controlled Trial
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryBélgica
hcfmusp.affiliation.countrySuíça
hcfmusp.affiliation.countryisoch
hcfmusp.affiliation.countryisobe
hcfmusp.author.externalBECK-SCHIMMER, Beatrice:Univ Zurich Hosp, Inst Anesthesiol, Raemistr 100, CH-8091 Zurich, Switzerland
hcfmusp.author.externalBONVINI, John M.:Univ Zurich Hosp, Inst Anesthesiol, Raemistr 100, CH-8091 Zurich, Switzerland
hcfmusp.author.externalSCHADDE, Erik:Univ Zurich Hosp, Dept Surg & Transplantat, Swiss HPB & Transplant Ctr, Raemistr 100, CH-8091 Zurich, Switzerland
hcfmusp.author.externalDUTKOWSKI, Philipp:Univ Zurich Hosp, Dept Surg & Transplantat, Swiss HPB & Transplant Ctr, Raemistr 100, CH-8091 Zurich, Switzerland
hcfmusp.author.externalOBERKOFLER, Christian E.:Univ Zurich Hosp, Dept Surg & Transplantat, Swiss HPB & Transplant Ctr, Raemistr 100, CH-8091 Zurich, Switzerland
hcfmusp.author.externalLESURTEL, Mickael:Univ Zurich Hosp, Dept Surg & Transplantat, Swiss HPB & Transplant Ctr, Raemistr 100, CH-8091 Zurich, Switzerland
hcfmusp.author.externalDEOLIVEIRA, Michelle L.:Univ Zurich Hosp, Dept Surg & Transplantat, Swiss HPB & Transplant Ctr, Raemistr 100, CH-8091 Zurich, Switzerland
hcfmusp.author.externalREYNTJENS, Koen:Ghent Univ Hosp, Dept Anaesthesiol, Ghent, Belgium
hcfmusp.author.externalWOUTERS, Patrick:Ghent Univ Hosp, Dept Anaesthesiol, Ghent, Belgium
hcfmusp.author.externalROGIERS, Xavier:Ghent Univ Hosp, Transplantat Ctr, Ghent, Belgium; Ghent Univ Hosp, Dept Gen & Hepatobiliary Surg, Ghent, Belgium
hcfmusp.author.externalDEBAERDEMAEKER, Luc:Ghent Univ Hosp, Dept Anaesthesiol, Ghent, Belgium
hcfmusp.author.externalGANTER, Michael T.:Univ Zurich Hosp, Inst Anesthesiol, Raemistr 100, CH-8091 Zurich, Switzerland
hcfmusp.author.externalWEBER, Achim:Univ Zurich Hosp, Inst Surg Pathol, CH-8091 Zurich, Switzerland
hcfmusp.author.externalPUHAN, Milo A.:Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA; Univ Zurich, Epidemiol Biostat & Prevent Inst, Zurich, Switzerland
hcfmusp.author.externalCLAVIEN, Pierre-Alain:Univ Zurich Hosp, Dept Surg & Transplantat, Swiss HPB & Transplant Ctr, Raemistr 100, CH-8091 Zurich, Switzerland
hcfmusp.author.externalBREITENSTEIN, Stefan:Univ Zurich Hosp, Dept Surg & Transplantat, Swiss HPB & Transplant Ctr, Raemistr 100, CH-8091 Zurich, Switzerland
hcfmusp.citation.scopus37
hcfmusp.contributor.author-fmusphcESTELA REGINA RAMOS FIGUEIRA
hcfmusp.contributor.author-fmusphcJOEL AVANCINI ROCHA FILHO
hcfmusp.contributor.author-fmusphcJOSE OTAVIO COSTA AULER JUNIOR
hcfmusp.contributor.author-fmusphcLUIZ AUGUSTO CARNEIRO D ALBUQUERQUE
hcfmusp.description.beginpage1606
hcfmusp.description.endpage1612
hcfmusp.description.issue8
hcfmusp.description.volume99
hcfmusp.origemWOS
hcfmusp.origem.pubmed25769076
hcfmusp.origem.scopus2-s2.0-84942416899
hcfmusp.origem.wosWOS:000369083800027
hcfmusp.publisher.cityPHILADELPHIA
hcfmusp.publisher.countryUSA
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