Temporary portocaval shunt provides superior intraoperative hemodynamics and reduces blood loss and duration of surgery in live donor liver transplantation. A randomized controlled trial.
Kumar M, Patil NS, Mohapatra N, Sindwani G, Dhingra U, Yadav A et al.
Ann Surg 2024; 279: 932-944.
A temporary shunt reduced intra-operative blood loss (P=0.004) and need for transfusion in this study of 60 procedures. The shunted patients were also more haemodynamically stable in the anhepatic phase, requiring less vasopressor support, with better postoperative renal function. There were no other differences in postoperative outcomes.
Comment: The observed advantages should improve outcomes, but perhaps the study was too small to be definitive.
16 August 2024
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