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Master Thesis

Impact de l'hyperoxie après reperfusion du greffon en transplantation hépatique orthotopique chez l'adulte

Abstract : Objective: The objective of our study was to evaluate the impact of hyperoxia after graft reperfusion during orthotopic liver transplantation in adults. Background: Hyperoxia is common in peri-operative liver transplantation without being supported by any recommendation. Recent studies, however, have shown the potential deleterious effect of hyperoxia in similar models of ischemia-reperfusion. Methods: We conducted a pilot, retrospective and monocentric study. All adult liver transplant patients from July 26, 2013 to December 26, 2017 were considered for inclusion. Patients were classified into two groups: a hyperoxic group (PaO2> 200mmhg) and a normoxic group (PaO2 <200 mmhg). The primary endpoint was arterial lactatemia 15 min after revascularization of the liver graft. Secondary endpoints included postoperative clinical outcomes and laboratory data. Results: A total of 222 liver transplant patients were included. Arterial lactatemia after graft revascularization was significantly higher in the hyperoxic group (6.03 ± 4 mmol/L) than in the normoxic group (4.81 ± 2 mmol/L), (p<0.01). The postoperative hepatic cytolysis peak, duration of mechanical ventilation and duration of ileus were significantly increased in the hyperoxic group. Conclusion: Our study suggests an increase in lactatemia and poor outcomes in patients with PaO2>200 mmhg after revascularization of the graft during liver transplantation. This could be the consequence of the aggravation of ischemia-reperfusion-induced lesions. A multicenter prospective study should be performed to confirm these results.
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Submitted on : Tuesday, November 19, 2019 - 12:31:13 PM
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Audrey Le Saux. Impact de l'hyperoxie après reperfusion du greffon en transplantation hépatique orthotopique chez l'adulte. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02370153⟩



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