Long term results of total caval clamping time in living donor liver transplantations

Aims: Observing the long term results of liver transplantation from living donor by total caval clamping technic retrospectively. Material and Methods: The effects of vena cava inferior clamping time on biochemical parameters, renal failure findings, morbidity, graft and patient survival were investigated retrospectively on 31 patients with live to live liver transplantation in Gaziantep University Research and Practice Hospital General Surgery Department since 2010 from 2015. Age, gender, Child, Meld scores, intraoperative anesthesia datas, preoperative and postoperative biochemical parameters and postoperative complications were investigated. Findings: 21(67%) of the patients participating in our study are male and 10(32%) are female. The average age is 43,48. The younger patient is 6 years old and the older patient is 63 years old. 71% of the patients in our study had NaMELD score between 10 and 20. CHILD score of 12 patients were CHILD B-7 and 3 patients were CHILD C-11. Operating time was maximum 11 hours, minimum 6 hours and average time was 8,29 hours. Total caval clamping time was maximum 135 minutes and average 81,29 minutes. 18 of 31 patients who were transplated were done blood transfusion after operation. 48,4% of patients were given vasopressor during operation. During 1 year period after operation 6 of 31 patients were died. 5 of these patients were died within 40 days after operation. It was founded statistically significant and moderately relation in a positive way between total caval clamping time and peak GGT level in 1 and 7 days postoperatively(p<0,05, r=0,527) (p<0,05, r=0,468). On the other hand, no significant relation was founded between total caval clamping time and peak creatinin level in 48 hours, 7 days and 1 year postoperatively. 1 year survival rate was 80,6%. It was seen that total clamping time had no significant effect on survival. Result: In living donor liver transplantation with total caval clamping technic, there was no statistically significant correlation between clamping time and long term renal failure,billiar system compications,morbidity and mortality. In the literature, there is not enough study on the long term effects of total caval clamping time and we think that more extensive studies are needed. Key Words: Living donor liver transplantation, total caval clamping technic, long term results