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The utility of using bispectral index monitoring as an early intraoperative indicator of initial poor graft function after orthotopic or split-graft liver transplantation
  1. A A Dahaba1,
  2. Z Y Feng2,
  3. S M Zhu2,
  4. H Bornemann1,
  5. P H Rehak3,
  6. H Metzler1
  1. 1
    Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Austria
  2. 2
    Department of Anaesthesiology, First Affiliated Hospital, College of Medicine, Zhe Jiang University, Hang Zhou, People's Republic of China
  3. 3
    Biomedical Engineering and Computing Unit of the department of Surgery, Medical University of Graz, Austria
  1. Dr S M Zhu, Department of Anaesthesiology, First Affiliated Hospital, College of Medicine, Zhe Jiang University, 79, Qingchun Road, Hang Zhou, Zhe Jiang 310003, Hang Zhou, People's Republic of China; smzhu20088{at}yahoo.com.cn

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We refer to our recent publication (Gut 2008;57:77–83) showing that bispectral index (BIS) monitoring, an electroencephalographic (EEG)-derived parameter, is a useful measure for grading and monitoring the degree of central nervous system involvement in patients with chronic liver disease. We further assessed its utility as an early intraoperative indicator of living-donor or cadaveric graft function. Initial poor graft function (IPGF) is a serious complication following liver transplantation, whereas primary non-function (PNF), the most serious type of IPGF, is a life threatening condition that occurs in about 5.8% of cases1 and requires emergency re-transplantation. Hence there is growing need for early identification of IPGF and PNF as this may help to determine further therapeutic interventions, changes in therapeutic protocols or additional diagnostic procedures aiming at preventing IPGF/PNF.

We investigated 29 patients undergoing living-donor liver transplantations (LDLTs) and 24 patients undergoing locally procured orthotopic liver transplantation (OLT) without venovenous bypass for end-stage liver disease …

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