A multicenter evaluation of safety of early extubation in liver transplant recipients

M. Susan Mandell, Tamara J. Stoner, Rebecca Barnett, Abraham Shaked, Mark Bellamy, Gianni Biancofiore, Claus Niemann, Ann Walia, Youri Vater, Zung V. Tran, Igal Kam

Research output: Contribution to journalArticlepeer-review

65 Scopus citations

Abstract

Small single-institutional studies performed prior to the introduction of organ allocation using the Model for End-Stage Liver Disease (MELD) suggest that early airway extubation of liver transplant recipients is a safe practice. We designed a multicenter study to examine adverse events associated with early extubation in patients selected for liver transplantation using MELD score. A total of 7 institutions extubated all patients meeting study criteria and reported adverse events that occurred within 72 hours following surgery. Adverse events were uncommon: occurring in only 7.7% of 391 patients studied. Most adverse events were pulmonary or surgically related. Pulmonary complications were usually minor, requiring only an increase in ambient oxygen concentration. The majority of surgical adverse events required additional surgery. Analysis of a limited set of perioperative variables suggest that blood transfusions and technical factors were associated with an increased risk of adverse events. In conclusion, while early extubation appears to be safe under specified circumstances, there are performance differences between institutions that remain to be explained.

Original languageEnglish (US)
Pages (from-to)1557-1563
Number of pages7
JournalLiver Transplantation
Volume13
Issue number11
DOIs
StatePublished - Nov 2007

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology
  • Transplantation

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