| PartiThe incidence and related risk factors of early acute renal dysfunction afterorthotopic liver transplantationObjectivesTo analyze the incidence and related risk factors of acute renal dysfunction early after orthotopic liver transplantation. It will be facilitated to prevention and treatment of eacute renal dysfunction after orthotopic liver transplantation.Materials and methods104 patients were included in this analysis. Veno-venous bypass was used in 42 patients ( group B ) and was not used in 62 patients(group A) .The diagnosis standard for early renal dysfunction is sCr>1.5mg/dl. The incidence of acute renal dysfunction early after OLT was compared between two groups. Meanwhile, the related risk factors of renal dysfunction early after operation without veno-venous bypass were analyzed with Logistic regression.ResultsThere were 5 and 4 patients whose serum Cr before operation was up the normal level in group A and B , respectively. There was no significance between the two groups. There was no significance in hemodynamic parameters during the operation in two groups . The operation time, the clamping duration of portal vein and inferior vena cava in group B were longer than that of group A .There were 16 (25.8%) and 11 patients (26.2%) whose sCr early after operation were upthe normal level in group A and B, respectively,(p<0.05). The sCr before operation, the bleeding volume during the operation, and the urine output were significant risk factors responsible for the acute renal dysfunction early after orthotopic liver transplantation. OR value was 1.047 ,1.00, 0.99, respectively.Conclusion1. The incidence of acute renal dysfunction early after OLT was 25.9%.2. Serum Cr before operation, bleeding volume and urine output during operation were significant risk factors responsible for acute renal dysfunction early after OLT.3. OLT without veno-venous bypass in the operation would not increase the incidence of acute renal dysfunction early after OLT[Key words] liver transplantation; veno-venous bypass; renal function; risk assessment; factor analysisPart IIEffects of anhepatic phase of orthotopic liver transplantation(OLT) on the gastrointestinal and renal function and precaution and treatment ofscopolamineObjectivesTo evaluate the Effects of anhepatic phase of orthotopic liver transplantation(OLT) on the gastrointestinal and renal function and precaution and treatment of scopolamineMaterials and methods30 patients undergoing OLT were randomly allocated to control group(group ns,n=15) and scopolamine group(Group s,n=15). For scopolamine group ,intravenous infusion of 200ml normal saline containing scopolamine O.OSmg/kgwere given 15min before unclamping of portal vein(PV) and early time of neohepatic period. The veno-venous bypass was not used in both groups. During the operation, hemodynamic parameters were monitored. The gastric mucosal Pco2(Pgco2), pH(pHi) was measured by balloon Tonometer. Hemodynamic parameters, Pgco2, pHi, gradient gap between gastric mucosal and arterial Pco2(Pg-aco2) at the time point of before operation(TO), 30min after clamping of PV(T1), 5min(T2), 30min(T3),90(T4)min after unclamping of PV, and the end of operation(TS) were recorded down and pHi was calculated by6formula of Henderson-Hasselbalch. Duration of operation, clamping time of PV, bleeding volume, infusion volume and urine output were also recorded down and the arterial samples were collected at the corresponding timepoints. Serum ALT,AST, and Cr were determined with an automatic biochemical analyzer. Blood MDA, SOD and P2-MG were determined by method of TBA, xanthine oxidase and enzyme-immune respectively. The endotoxin of artery was determined at the corresponding timepoints.Results1. No statistically significant differences were found in the underlying diseases, age, weights, duration of operation, clamping time of PV, infusion volume during the operation, et al, between two groups. Compared with Group ns, urine output were sign...
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