The effect of using the algorithm of restrictive intraoperative fluid therapy, early immune enteral nutrition, and early patient mobilization on orthotopic liver transplantation outcomes
Abstract
Major surgical procedures induce a number of pathophysiological responses, which may lead to a significant increase in perioperative complications, delayed recovery and rehabilitation, and longer hospital stays. Fast-track surgery, also known as enhanced recovery after surgery (ERAS) or as multimodal surgery, aims at decreasing the frequency of postoperative complications, creating optimal conditions for earlier postoperative recovery and return to normal life activities.
The implementation of fast-track programs results in a reduced treatment duration without increase in readmissions. In this article, we have described our experience in the application of fast track program components to improve the outcomes after liver transplantation.
About the Authors
A. M. Dzyadz'ko
City Clinical Hospital No. 9, Minsk
Belarus
Belarus
Cand.Med.Sci. Associate Professor, Head of Anesthesiology and Intensive Care Department
M. L. Katin
City Clinical Hospital No. 9, Minsk
Belarus
Belarus
O. A. Chugunova
City Clinical Hospital No. 9, Minsk
Belarus
Belarus
A. F. Minov
City Clinical Hospital No. 9, Minsk
Belarus
Belarus
E. G. Oganova
City Clinical Hospital No. 9, Minsk
Belarus
Belarus
E. O. Santotskiy
City Clinical Hospital No. 9, Minsk
Belarus
Belarus
A. E. Shcherba
City Clinical Hospital No. 9, Minsk
Belarus
Belarus
O. O. Rummo
City Clinical Hospital No. 9, Minsk
Belarus
Belarus
I. I. Kanus
Belarusian Medical Academy of Post-Graduate Education, Minsk
Belarus
Belarus
References
1. Salvalaggio P.R., Felga G.E., Afonso R.C., Ferraz-Neto B.H. Early allograft dysfunction and liver transplant outcomes: a single center retrospective study. Transplant Proc. 2012;44(8):2449–2451. doi: 10.1016/j. transproceed.2012.08.002.
2. Kehlet H., Wilmore D.W. Multimodal strategies to improve surgical outcome. Am J Surg. 2002;183(6):630–641.
3. Newsletter transplant. International figures on donation and transplantation 2014. EDQM, 2015; 20. 64 p.
4. Rummo O.O. Correction of early postoperative complications after liver transplantation. Kletochnaya i organnaya transplantologiya. 2014;2:116–121. (In Russian).
5. Kehlet H., Wilmore D.W. Evidencebased surgical care and the evolution of fast-track surgery. Ann Surg. 2008;248(2):189–198. doi: 10.1097/ SLA.0b013e31817f2c1a.
6. Kehlet H., Wilmore D.W. Management of patients in fast track surgery. BMJ. 2001;322(7284):473–476.
7. Gatt M., Khan S., MacFie J. In response to: Varadhan K.K., Neal K.R., Dejong C.H., Fearon K.C., Ljungqvist O., Lobo D.N. Theenhanced recovery after surgery (ERAS) pathway for patients undergoing major electiveopen colorectal surgery: a meta-analysis of randomized controlled trials. Clin Nutr. 2010;29:434–440. Clin Nutr. 2010;29(5):689–690. doi: 10.1016/j. clnu.2010.06.005.
8. Gustafsson U.O., Scott M.J., Schwenke W., et al. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS®). Society recommendations. Clin Nutr. 2012;31(6):783–800.
9. Miyaoka Y., Miyajima A. To divide or not to divide: revisiting liver regeneration. Cell Div. 2013;8(1):8. doi: 10.1186/1747-1028-8-8.
10. Blood and Transplant: annual report on liver transplantation. Report for 2013/2014 (1 april 2004 – 31 march 2014). Produced in collaboration with NHS. England, 2014. 76 p.
11. Stickel F., Inderbitzin D., Candinas D. Role of nutrition in liver transplantation for end-stage chronic liver disease. Nutr Rev. 2008;66(1):47–54. doi: 10.1111/j.1753-4887.2007.00005.x.
12. Sanchez A.J., Aranda-Michel J. Nutrition for the LiverTransplant Patient. Liver Transpl. 2006;12(9):1310– 1316.
13. Dasarathy S. Treatment to improve nutrition and functional capacity evaluation in liver transplant candidates. Curr Treat Options Gastroenterol. 2014;12(2):242–255. doi: 10.1007/s11938- 014-0016-9.
14. Kiselev V.V., Zhuravel' S.V., Tsarenko S.V., Chzhao A.V. The combined health food after extensive resection of liver. Obshch reanimatol. 2007;5-6:182–186. (In Russian).
15. Plank L.D., McCall J.L., Gane E.J., et al. Preand postoperative immunonutrition in patients undergoing liver transplantation: A pilot study of safety and efficacy. Clin Nutr. 2005;24(2):288–296.
16. Masuda T., Shirabe K., Yoshiya S. Nutrition support and infections associated with hepatic resection and liver transplantation in patients with chronic liver disease. JPEN J Parenter Enteral Nutr. 2013;37(3):318–326. doi: 10.1177/0148607112456041.
17. Nagata S., Shirabe K., Sugimachi K., et al. Pilot study of preoperative immunonutrition with antioxidants in living donor liver transplantation donors. Fukuoka Igaku Zasshi. 2013;104(12):530– 538.
18. Senkal M., Mumme A., Eickhoff U., et al. Early postoperative enteral immunonutrition: clinical outcome and cost-comparison analysis in surgical patients. Crit Care Med. 1997;25(9):1489– 1496.
Review
For citations:
Dzyadz'ko A.M., Katin M.L., Chugunova O.A., Minov A.F., Oganova E.G., Santotskiy E.O., Shcherba A.E., Rummo O.O., Kanus I.I. The effect of using the algorithm of restrictive intraoperative fluid therapy, early immune enteral nutrition, and early patient mobilization on orthotopic liver transplantation outcomes. Transplantologiya. The Russian Journal of Transplantation. 2016;(3):10-20.
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