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Gestion des risques en transplantation hépatique : la consultation chirurgicale pré-greffe prédit elle la difficulté peropératoire ?
Mémoire de Master / Thèse d'exercice

Gestion des risques en transplantation hépatique : la consultation chirurgicale pré-greffe prédit elle la difficulté peropératoire ?

Simon Roucaute
Masters , Université de Montpellier
20/10/2022

Résumé

Difficulty scale Complexity Anticipation Niveau de difficulté Complexité Anticipation Gestion du risque Transplantation hépatique Risk management Liver transplantation
Methods: such a definition was the combination of the number of blood units transfused, cold ischemia time, and duration of operation, all above the median value of the entire population. We also assessed hepatectomy difficulty with the combination of the number of blood units transfused and duration of hepatectomy, all above the median value of the entire population. We conducted our study in Montpellier University Hospital with patients data dating from 2014 to 2022. Results: the study population included 413 patients. The incidence of Diff-LT was 18.9% (similar to the results of Azoulay et al). The “difficult LT” or “difficult hepatectomy” were not associated with 90-day mortality increasing. The “difficult LT” was associated with MELD score > 30, former alcoholic hepatitis, anticipation of unconventional vascular reconstruction, and previous LT for preoperative factors. A “difficult hepatectomy” was associated with a MELD score > 30 and secondary biliary cirrhosis for preoperative factors. Conclusion: Diff –LT and Diff-Hepatectomy, have occurred frequently. Patient severity (MELD score > 30) is the only common preoperative factor. We need to rename the surgical difficulty, with surgical duration or other technical data, separated from surgical complications with blood cells transfusion, or other hemodynamic data.

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