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| Enhanced recovery after surgery in perioperative period of liver transplantation |
| Jiang-Juan He a , Lei Geng b , Zhuo-Yi Wang c , Shu-Sen Zheng b , c , d , ∗ |
a Department of Infection Management, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
b Division of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
c Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Zhejiang Shuren University School of Medicine, Hangzhou 310022, China
d NHC Key Laboratory of Combined Multi-organ Transplantation, Hangzhou 310003, China
∗ Corresponding author at: Division of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
E-mail address: shusenzheng@zju.edu.cn (S.-S. Zheng). |
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Abstract End-stage liver disease (ESLD) usually causes multi-organ dysfunction which increases the risk for perioperative complications and mortality [1]. Liver transplantation is the only curative therapy for ESLD. However, liver transplantation is a major and challenging surgery with a great level of complexity as a result of the interaction between donor and recipient factors. Consequently, this procedure brings a high risk of complications that significantly affect 1-year mortality and graft loss [2]. In addition, immunosuppressant applications are required postoperatively. These factors make perioperative care of patients with liver disease complicated, and the risk of poor patient prognosis increases accordingly. Optimized perioperative management strategies benefit the patient rehabilitation and prolong survival. Enhanced recovery after surgery (ERAS) is a multimodal and evidence-based program of care to minimize the surgical stress, reduce perioperative morbidity and hospital stay [3] . ERAS strategies have been widely used in many fields for nearly 20 years, including colorectal, urological, orthopedics and other surgeries. However, as hepatic surgery differs significantly from colorectal or urological surgery in terms of underlying disease, comorbidities, metabolic stress response and organ-specific complications, the content of ERAS program for liver transplantation is specific. Although studies verified that ERAS is safe and effective in liver transplantation [4,5], it has not yet been widely accepted. This study summarized ERAS strategies of perioperative liver transplantation based on evidence-based medicine, and evaluated the effectiveness on clinical application.
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2022, Vol. 21 
