TY - JOUR
T1 - Guidelines for Perioperative Care for Liver Transplantation
T2 - Enhanced Recovery after Surgery (ERAS) Recommendations
AU - Brustia, Raffaele
AU - Monsel, Antoine
AU - Skurzak, Stefano
AU - Schiffer, Eduardo
AU - Carrier, François Martin
AU - Patrono, Damiano
AU - Kaba, Abdourahamane
AU - Detry, Olivier
AU - Malbouisson, Luiz
AU - Andraus, Wellington
AU - Vandenbroucke-Menu, Franck
AU - Biancofiore, Gianni
AU - Kaido, Toshimi
AU - Compagnon, Philippe
AU - Uemoto, Shinji
AU - Rodriguez Laiz, Gonzalo
AU - De Boer, Marieke
AU - Orloff, Susan
AU - Melgar, Paola
AU - Buis, Carlijn
AU - Zeillemaker-Hoekstra, Miriam
AU - Usher, Helen
AU - Reyntjens, Koen
AU - Baird, Emily
AU - Demartines, Nicolas
AU - Wigmore, Stephen
AU - Scatton, Olivier
N1 - Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Background. Enhanced Recovery After Surgery (ERAS) is a multimodal, evidence-based, program of care developed to minimize the response to surgical stress, associated with reduced perioperative morbidity and hospital stay. This study presents the specific ERAS Society recommendations for liver transplantation (LT) based on the best available evidence and on expert consensus Methods. PubMed and ClinicalTrials.gov were searched in April 2019 for published and ongoing randomized clinical trials on LT in the last 15 y. Studies were selected by 5 independent reviewers and were eligible if focusing on each validated ERAS item in the area of adult LT. An e-Delphi method was used with an extended interdisciplinary panel of experts to validate the final recommendations. Results. Forty-three articles were included in the systematic review. A consensus was reached among experts after the second round. Patients should be screened for malnutrition and treated whenever possible. Prophylactic nasogastric intubation and prophylactic abdominal drainage may be omitted, and early extubation should be considered. Early oral intake, mobilization, and multimodal-balanced analgesia are recommended. Conclusions. The current ERAS recommendations were elaborated based on the best available evidence and endorsed by the e-Delphi method. Nevertheless, prospective studies need to confirm the clinical use of the suggested protocol.
AB - Background. Enhanced Recovery After Surgery (ERAS) is a multimodal, evidence-based, program of care developed to minimize the response to surgical stress, associated with reduced perioperative morbidity and hospital stay. This study presents the specific ERAS Society recommendations for liver transplantation (LT) based on the best available evidence and on expert consensus Methods. PubMed and ClinicalTrials.gov were searched in April 2019 for published and ongoing randomized clinical trials on LT in the last 15 y. Studies were selected by 5 independent reviewers and were eligible if focusing on each validated ERAS item in the area of adult LT. An e-Delphi method was used with an extended interdisciplinary panel of experts to validate the final recommendations. Results. Forty-three articles were included in the systematic review. A consensus was reached among experts after the second round. Patients should be screened for malnutrition and treated whenever possible. Prophylactic nasogastric intubation and prophylactic abdominal drainage may be omitted, and early extubation should be considered. Early oral intake, mobilization, and multimodal-balanced analgesia are recommended. Conclusions. The current ERAS recommendations were elaborated based on the best available evidence and endorsed by the e-Delphi method. Nevertheless, prospective studies need to confirm the clinical use of the suggested protocol.
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U2 - 10.1097/TP.0000000000003808
DO - 10.1097/TP.0000000000003808
M3 - Article
C2 - 33966024
AN - SCOPUS:85125006375
SN - 0041-1337
VL - 106
SP - 552
EP - 561
JO - Transplantation
JF - Transplantation
IS - 3
ER -