Orthotopic Liver Transplantation Without Venovenous Bypass: 125 Cases From a Single Center

Abstract Aim This study analyzed a 10-year single-center experience in orthotopic liver transplantation (OLT) without venovenous bypass (VVB). Methods We retrospectively analysed a nonrandomized series (1999-2008) of 125 adult OLT patients without VVB. Results The main causes of liver failure were viral hepatitis ( n = 39), alcoholic liver disease ( n = 22), and liver cancer ( n = 17). One-year survival was 76.4%. The most common postoperative complications were bile duct stenosis ( n = 12), postoperative bleeding ( n = 8), hepatic artery thrombosis ( n = 7), and primary liver failure ( n = 6). Twelve patients required hemodialysis and four underwent retransplantations of the liver. Fourteen patients died before postoperative day 30th . Univariate analysis showed significant differences between patients who did and did not survive 30 days among donor death diagnoses ( P = .05), red blood cell units transfused ( P = .03), aspartate aminotranferase on the first postoperative day ( P = .002), ABO type ( P = .04), time of orotracheal intubation ( P = .001), hemodialysis ( P = .001), and period of postoperative vasoactive drug use ( P = .006). The total length of orotracheal tube intubation showed a significant independent association with mortality before 30 days ( P < .001). Conclusion OLT without VVB can be safely performed even in severe cases of chronic liver failure.