Data from: Prospective randomized trial comparing hepatic venous outflow and renal function after conventional versus piggyback liver transplantation

Background: This randomized prospective clinical trial compared the
hepatic venous outflow drainage and renal function after conventional with
venovenous bypass (n = 15) or piggyback (n = 17) liver transplantation.
Methods: Free hepatic vein pressure (FHVP) and central venous pressure
(CVP) measurements were performed after graft reperfusion. Postoperative
serum creatinine (Cr) was measured daily on the first week and on the
14th, 21st and 28th postoperative days (PO). The prevalence of acute renal
failure (ARF) up to the 28th PO was analyzed by RIFLE-AKIN criteria. A
Generalized Estimating Equation (GEE) approach was used for comparison of
longitudinal measurements of renal function. Results: FHVP-CVP gradient
> 3 mm Hg was observed in 26.7% (4/15) of the patients in the
conventional group and in 17.6% (3/17) in the piggyback group (p = 0.68).
Median FHVP-CVP gradient was 2 mm Hg (0–8 mmHg) vs. 3 mm Hg (0–7 mm Hg) in
conventional and piggyback groups, respectively (p = 0.73). There is no
statistically significant difference between the conventional (1/15) and
the piggyback (2/17) groups regarding massive ascites development (p =
1.00). GEE estimated marginal mean for Cr was significantly higher in
conventional than in piggyback group (2.14 ± 0.26 vs. 1.47 ± 0.15 mg/dL; p
= 0.02). The conventional method presented a higher prevalence of severe
ARF during the first 28 PO days (OR = 3.207; 95% CI, 1.010 to 10.179; p =
0.048). Conclusion: Patients submitted to liver transplantation using
conventional or piggyback methods present similar results regarding venous
outflow drainage of the graft. Conventional with venovenous bypass
technique significantly increases the harm of postoperative renal
dysfunction.