Efficacy and safety of enhanced recovery after surgery in liver transplantation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XIE Zerong ¹ ,  WU Menghang ¹ , REN Qiuping ¹ , WANG Shouping ² , TAN Yifei ¹

1. Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Intensive Care Unit, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WU Menghang, Email: wumh1126@126.com

Keywords：

enhanced recovery after surgery; liver transplantation; complication

DOI：

10.7507/1007-9424.202005069

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To review the effect and safety of enhanced recovery after surgery (ERAS) in liver transplant recipients.Methods A comprehensive literature search of Pubmed, Embase, CNKI, etc. was performed using keywords “ERAS” or “fast track” and “liver transplantation” (cut-off date June 3, 2020). The relevant literatures on researches of ERAS in liver transplant recipients at home and abroad in recent years were summarized.Results ERAS effectively could promote the functional recovery of postoperative food intake and physical activities through systemic perioperative measures different from conventional management among the liver transplant recipients. In addition, loads of studies had revealed that ERAS was safe for liver transplant recipients with positive effects in different dimensions such as controlling complications, shortening hospital stays, and reducing medical expenses, etc.Conclusion ERAS can effectively promote functional recovery of liver transplant recipients without increasing risk.

Citation： XIE Zerong, WU Menghang, REN Qiuping, WANG Shouping, TAN Yifei. Efficacy and safety of enhanced recovery after surgery in liver transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(11): 1463-1468. doi: 10.7507/1007-9424.202005069 Copy

1.	Xu QQ, Zhu M, Li Z, et al. Enhanced recovery after surgery protocols in patients undergoing liver transplantation: A retrospective comparative cohort study. Int J Surg, 2020, 78: 108-112.
2.	Rouxel P, Beloeil H. Enhanced recovery after hepatectomy: A systematic review. Anaesth Crit Care Pain Med, 2019, 38(1): 29-34.
3.	Lee S, Sa GJ, Kim SY, et al. Intraoperative predictors of early tracheal extubation after living-donor liver transplantation. Korean J Anesthesiol, 2014, 67(2): 103-109.
4.	Wischmeyer PE, Carli F, Evans DC, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on nutrition screening and therapy within a surgical enhanced recovery pathway. Anesth Analg, 2018, 126(6): 1883-1895.
5.	Brustia R, Monsel A, Conti F, et al. Enhanced recovery in liver transplantation: A feasibility study. World J Surg, 2019, 43(1): 230-241.
6.	汪守平, 张中伟, 杨家印, 等. 加速康复外科集束化管理在肝移植中的应用. 中华器官移植杂志, 2018, 39(3): 149-153.
7.	Rao JH, Zhang F, Lu H, et al. Effects of multimodal fast-track surgery on liver transplantation outcomes. Hepatobiliary Pancreat Dis Int, 2017, 16(4): 364-369.
8.	Shi MY, Hu ZQ, Yang DJ, et al. Preoperative oral carbohydrate reduces postoperative insulin resistance by activating AMP-activated protein kinase after colorectal surgery. Dig Surg, 2002, 35(5): 368-375.
9.	Wang FR, Sun DW, Zhang NN, et al. The efficacy and safety of controlled low central venous pressure for liver resection: a systematic review and meta-analysis. Gland Surg, 2020, 9(2): 311-320.
10.	Wang B, He HK, Cheng B, et al. Effect of low central venous pressure on postoperative pulmonary complications in patients undergoing liver transplantation. Surg Today, 2013, 43(7): 777-781.
11.	Carrier FM, Chassé M, Wang HT, et al. Restrictive fluid management strategies and outcomes in liver transplantation: a systematic review. Can J Anaesth, 2020, 67(1): 109-127.
12.	Blaszczyk B, Wronska B, Klukowski M, et al. Factors affecting breathing capacity and early tracheal extubation after liver transplantation: analysis of 506 cases. Transplant Proc, 2016, 48(5): 1692-1696.
13.	Sahinturk H, Ozdemirkan A, Yilmaz O, et al. Immediate tracheal extubation after pediatric liver transplantation. Exp Clin Transplant, 2018 Oct 19. doi: 10.6002/ect.2018.0067.
14.	Duarte RP, da Silva AMO, Tonella RM, et al. Model for End-Stage Liver Disease Score before hepatic transplantation and root mean square of the diaphragmatic domes affect postoperative extubation time. Transplant Proc, 2018, 50(3): 776-778.
15.	Santer P, Zheng S, Hammer M, et al. Ventilatory frequency during intraoperative mechanical ventilation and postoperative pulmonary complications: a hospital registry study. Br J Anaesth, 2020, 125(1): e130-e139.
16.	Zhang WL, Wang WT, Kang M, et al. Bacterial and fungal infections after liver transplantation: microbial epidemiology, risk factors for infection and death with infection. Ann Transplant, 2020, 25: e921591.
17.	Rossaint R, Slama K, Jaeger M, et al. Fluid restriction and early extubation for successful liver transplantation. Transplant Proc, 1990, 22(4): 1533-1534.
18.	Mandell MS, Lockrem J, Kelley SD. Immediate tracheal extubation after liver transplantation: experience of two transplant centers. Anesth Analg, 1997, 84(2): 249-253.
19.	杨家印, 严律南. 以早期气管拔管为主的快速康复在肝移植手术中的应用. 中国普外基础与临床杂志, 2018, 25(8): 900-904.
20.	Glanemann M, Langrehr J, Kaisers U, et al. Postoperative tracheal extubation after orthotopic liver transplantation. Acta Anaesthesiol Scand, 2001, 45(3): 333-339.
21.	Li J, Wang C, Jiang Y, et al. Immediate versus conventional postoperative tracheal extubation for enhanced recovery after liver transplantation: IPTE versus CTE for enhanced recovery after liver transplantation. Medicine, 2018, 97(45): e13082.
22.	Biancofiore G, Tomescu DR, Mandell MS. Rapid recovery of liver transplantation recipients by implementation of fast-track care steps: what is holding Us back? Semin Cardiothorac Vasc Anesth, 2018, 22(2): 191-196.
23.	Echeverri J, Goldaracena N, Singh AK, et al. Avoiding ICU admission by using a fast-track protocol is safe in selected adult-to-adult live donor liver transplant recipients. Transplant Direct, 2017, 3(10): e213.
24.	Lemon K, Al-Khafaji A, Humar A. Critical care management of living donor liver transplants. Crit Care Clin, 2019, 35(1): 107-116.
25.	Ribeiro HS, Coury NC, de Vasconcelos Generoso S, et al. Energy balance and nutrition status: a prospective assessment of patients undergoing liver transplantation. Nutr Clin Pract, 2020, 35(1): 126-132.
26.	宁燕文. 快速康复理念在肝移植围手术期的应用. 实用临床护理学杂志, 2017, 2(50): 87-88.
27.	Hammad A, Kaido T, Aliyev V, et al. Nutritional therapy in liver transplantation. Nutrients, 2017, 9(10): 1126.
28.	Stratton RJ, Hebuterne X, Elia M. A systematic review and meta-analysis of the impact of oral nutritional supplements on hospital readmissions. Ageing Res Rev, 2013, 12(4): 884-897.
29.	Martos-Benítez FD, Gutiérrez-Noyola A, Soto-García A, et al. Program of gastrointestinal rehabilitation and early postoperative enteral nutrition: a prospective study. Updates Surg, 2018, 70(1): 105-112.
30.	Kaido T, Shinoda M, Inomata Y, et al. Effect of herbal medicine daikenchuto on oral and enteral caloric intake after liver transplantation: A multicenter, randomized controlled trial. Nutrition (Burbank, Los Angeles County, Calif), 2018, 54: 68-75.
31.	Yip VS, Dunne DF, Samuels S, et al. Adherence to early mobilisation: Key for successful enhanced recovery after liver resection. Eur J Surg Oncol, 2016, 42(10): 1561-1567.
32.	Melloul E, Hubner M, Scott M, et al. Guidelines for perioperative care for liver surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations. World J Surg, 2016, 40(10): 2425-2440.
33.	Harder-Lauridsen NM, Nielsen ST, Mann SP, et al. The effect of alternate-day caloric restriction on the metabolic consequences of 8 days of bed rest in healthy lean men: a randomized trial. J Appl Physiol (1985), 2017, 122(2): 230-241.
34.	King AB, Kensinger CD, Shi Y, et al. Intensive care unit enhanced recovery pathway for patients undergoing orthotopic liver transplants recipients: a prospective, observational study. Anesth Analg, 2018, 126(5): 1495-1503.
35.	Loh CA, Croome KP, Burcin Taner C, et al. Bias-corrected estimates of reduction of post-surgery length of stay and corresponding cost savings through the widespread national implementation of fast-tracking after liver transplantation: a quasi-experimental study. J Med Econ, 2019, 22(7): 684-690.
36.	Yataco M, Cowell A, David W, et al. Predictors and impacts of hospital readmissions following liver transplantation. Ann Hepatol, 2016, 15(3): 356-362.
37.	Taner CB, Willingham DL, Bulatao IG, et al. Is a mandatory intensive care unit stay needed after liver transplantation? Feasibility of fast-tracking to the surgical ward after liver transplantation. Liver Transpl, 2012, 18(3): 361-369.
38.	李妍. 快速康复外科理念在肝移植手术护理中的应用效果. 现代医学与健康研究, 2019, 3(4): 109-111.
39.	Elia M, Normand C, Norman K, et al. A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in the hospital setting. Clin Nutr, 2016, 35(2): 370-380.

1. Xu QQ, Zhu M, Li Z, et al. Enhanced recovery after surgery protocols in patients undergoing liver transplantation: A retrospective comparative cohort study. Int J Surg, 2020, 78: 108-112.
2. Rouxel P, Beloeil H. Enhanced recovery after hepatectomy: A systematic review. Anaesth Crit Care Pain Med, 2019, 38(1): 29-34.
3. Lee S, Sa GJ, Kim SY, et al. Intraoperative predictors of early tracheal extubation after living-donor liver transplantation. Korean J Anesthesiol, 2014, 67(2): 103-109.
4. Wischmeyer PE, Carli F, Evans DC, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on nutrition screening and therapy within a surgical enhanced recovery pathway. Anesth Analg, 2018, 126(6): 1883-1895.
5. Brustia R, Monsel A, Conti F, et al. Enhanced recovery in liver transplantation: A feasibility study. World J Surg, 2019, 43(1): 230-241.
6. 汪守平, 张中伟, 杨家印, 等. 加速康复外科集束化管理在肝移植中的应用. 中华器官移植杂志, 2018, 39(3): 149-153.
7. Rao JH, Zhang F, Lu H, et al. Effects of multimodal fast-track surgery on liver transplantation outcomes. Hepatobiliary Pancreat Dis Int, 2017, 16(4): 364-369.
8. Shi MY, Hu ZQ, Yang DJ, et al. Preoperative oral carbohydrate reduces postoperative insulin resistance by activating AMP-activated protein kinase after colorectal surgery. Dig Surg, 2002, 35(5): 368-375.
9. Wang FR, Sun DW, Zhang NN, et al. The efficacy and safety of controlled low central venous pressure for liver resection: a systematic review and meta-analysis. Gland Surg, 2020, 9(2): 311-320.
10. Wang B, He HK, Cheng B, et al. Effect of low central venous pressure on postoperative pulmonary complications in patients undergoing liver transplantation. Surg Today, 2013, 43(7): 777-781.
11. Carrier FM, Chassé M, Wang HT, et al. Restrictive fluid management strategies and outcomes in liver transplantation: a systematic review. Can J Anaesth, 2020, 67(1): 109-127.
12. Blaszczyk B, Wronska B, Klukowski M, et al. Factors affecting breathing capacity and early tracheal extubation after liver transplantation: analysis of 506 cases. Transplant Proc, 2016, 48(5): 1692-1696.
13. Sahinturk H, Ozdemirkan A, Yilmaz O, et al. Immediate tracheal extubation after pediatric liver transplantation. Exp Clin Transplant, 2018 Oct 19. doi: 10.6002/ect.2018.0067.
14. Duarte RP, da Silva AMO, Tonella RM, et al. Model for End-Stage Liver Disease Score before hepatic transplantation and root mean square of the diaphragmatic domes affect postoperative extubation time. Transplant Proc, 2018, 50(3): 776-778.
15. Santer P, Zheng S, Hammer M, et al. Ventilatory frequency during intraoperative mechanical ventilation and postoperative pulmonary complications: a hospital registry study. Br J Anaesth, 2020, 125(1): e130-e139.
16. Zhang WL, Wang WT, Kang M, et al. Bacterial and fungal infections after liver transplantation: microbial epidemiology, risk factors for infection and death with infection. Ann Transplant, 2020, 25: e921591.
17. Rossaint R, Slama K, Jaeger M, et al. Fluid restriction and early extubation for successful liver transplantation. Transplant Proc, 1990, 22(4): 1533-1534.
18. Mandell MS, Lockrem J, Kelley SD. Immediate tracheal extubation after liver transplantation: experience of two transplant centers. Anesth Analg, 1997, 84(2): 249-253.
19. 杨家印, 严律南. 以早期气管拔管为主的快速康复在肝移植手术中的应用. 中国普外基础与临床杂志, 2018, 25(8): 900-904.
20. Glanemann M, Langrehr J, Kaisers U, et al. Postoperative tracheal extubation after orthotopic liver transplantation. Acta Anaesthesiol Scand, 2001, 45(3): 333-339.
21. Li J, Wang C, Jiang Y, et al. Immediate versus conventional postoperative tracheal extubation for enhanced recovery after liver transplantation: IPTE versus CTE for enhanced recovery after liver transplantation. Medicine, 2018, 97(45): e13082.
22. Biancofiore G, Tomescu DR, Mandell MS. Rapid recovery of liver transplantation recipients by implementation of fast-track care steps: what is holding Us back? Semin Cardiothorac Vasc Anesth, 2018, 22(2): 191-196.
23. Echeverri J, Goldaracena N, Singh AK, et al. Avoiding ICU admission by using a fast-track protocol is safe in selected adult-to-adult live donor liver transplant recipients. Transplant Direct, 2017, 3(10): e213.
24. Lemon K, Al-Khafaji A, Humar A. Critical care management of living donor liver transplants. Crit Care Clin, 2019, 35(1): 107-116.
25. Ribeiro HS, Coury NC, de Vasconcelos Generoso S, et al. Energy balance and nutrition status: a prospective assessment of patients undergoing liver transplantation. Nutr Clin Pract, 2020, 35(1): 126-132.
26. 宁燕文. 快速康复理念在肝移植围手术期的应用. 实用临床护理学杂志, 2017, 2(50): 87-88.
27. Hammad A, Kaido T, Aliyev V, et al. Nutritional therapy in liver transplantation. Nutrients, 2017, 9(10): 1126.
28. Stratton RJ, Hebuterne X, Elia M. A systematic review and meta-analysis of the impact of oral nutritional supplements on hospital readmissions. Ageing Res Rev, 2013, 12(4): 884-897.
29. Martos-Benítez FD, Gutiérrez-Noyola A, Soto-García A, et al. Program of gastrointestinal rehabilitation and early postoperative enteral nutrition: a prospective study. Updates Surg, 2018, 70(1): 105-112.
30. Kaido T, Shinoda M, Inomata Y, et al. Effect of herbal medicine daikenchuto on oral and enteral caloric intake after liver transplantation: A multicenter, randomized controlled trial. Nutrition (Burbank, Los Angeles County, Calif), 2018, 54: 68-75.
31. Yip VS, Dunne DF, Samuels S, et al. Adherence to early mobilisation: Key for successful enhanced recovery after liver resection. Eur J Surg Oncol, 2016, 42(10): 1561-1567.
32. Melloul E, Hubner M, Scott M, et al. Guidelines for perioperative care for liver surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations. World J Surg, 2016, 40(10): 2425-2440.
33. Harder-Lauridsen NM, Nielsen ST, Mann SP, et al. The effect of alternate-day caloric restriction on the metabolic consequences of 8 days of bed rest in healthy lean men: a randomized trial. J Appl Physiol (1985), 2017, 122(2): 230-241.
34. King AB, Kensinger CD, Shi Y, et al. Intensive care unit enhanced recovery pathway for patients undergoing orthotopic liver transplants recipients: a prospective, observational study. Anesth Analg, 2018, 126(5): 1495-1503.
35. Loh CA, Croome KP, Burcin Taner C, et al. Bias-corrected estimates of reduction of post-surgery length of stay and corresponding cost savings through the widespread national implementation of fast-tracking after liver transplantation: a quasi-experimental study. J Med Econ, 2019, 22(7): 684-690.
36. Yataco M, Cowell A, David W, et al. Predictors and impacts of hospital readmissions following liver transplantation. Ann Hepatol, 2016, 15(3): 356-362.
37. Taner CB, Willingham DL, Bulatao IG, et al. Is a mandatory intensive care unit stay needed after liver transplantation? Feasibility of fast-tracking to the surgical ward after liver transplantation. Liver Transpl, 2012, 18(3): 361-369.
38. 李妍. 快速康复外科理念在肝移植手术护理中的应用效果. 现代医学与健康研究, 2019, 3(4): 109-111.
39. Elia M, Normand C, Norman K, et al. A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in the hospital setting. Clin Nutr, 2016, 35(2): 370-380.

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