{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:15:08Z","timestamp":1782778508439,"version":"3.54.5"},"reference-count":56,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,5,9]],"date-time":"2013-05-09T00:00:00Z","timestamp":1368057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>During liver transplant (<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>), the release of vasoactive substances into the systemic circulation is associated with severe hemodynamic instability that is injurious to the recipient and\/or the post\u2010ischemic graft. Crystalloid flush with backward unclamping (<jats:styled-content style=\"fixed-case\">CB<\/jats:styled-content>) and portal blood flush with forward unclamping (<jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content>) are two reperfusion methods to reduce reperfusion\u2010related cardiovascular perturbations in our center. The primary aim of this study was to compare these two methods. After institutional review board (<jats:styled-content style=\"fixed-case\">IRB<\/jats:styled-content>) approval, cadaveric whole <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content> cases performed between 2003 and 2008 were reviewed. Patients were divided into two groups based on reperfusion methods: <jats:styled-content style=\"fixed-case\">CB<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content>. After background matching with propensity score, the effect of each method on post\u2010operative graft function was assessed in detail. In our cohort of 478 patients, <jats:styled-content style=\"fixed-case\">CB<\/jats:styled-content> was used in 313 grafts and <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content> in 165. Thirty\u2010day graft survival was lower, and risk of retransplantation was higher in <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content>. Multivariable model showed that <jats:styled-content style=\"fixed-case\">CB<\/jats:styled-content> is an independent factor to reduce primary non\u2010function, cardiac arrest and improve 30\u2010d graft survival. Also, the incidence of ischemic\u2010type biliary lesions was significantly higher in the <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content> group. Reperfusion methods affect intraoperative hemodynamics and post\u2010transplant outcome. <jats:styled-content style=\"fixed-case\">CB<\/jats:styled-content> allows for control over temperature and composition of the perfusate, perfusion pressure, and the rate of infusion.<\/jats:p>","DOI":"10.1111\/ctr.12130","type":"journal-article","created":{"date-parts":[[2013,5,9]],"date-time":"2013-05-09T07:37:10Z","timestamp":1368085030000},"page":"492-502","source":"Crossref","is-referenced-by-count":18,"title":["Crystalloid flush with backward unclamping may decrease post\u2010reperfusion cardiac arrest and improve short\u2010term graft function when compared to portal blood flush with forward unclamping during liver transplantation"],"prefix":"10.1111","volume":"27","author":[{"given":"Kyota","family":"Fukazawa","sequence":"first","affiliation":[{"name":"Division of Solid Organ Transplantation, Department of Anesthesiology, Perioperative Medicine and Pain Management University of Miami Miller School of Medicine Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seigo","family":"Nishida","sequence":"additional","affiliation":[{"name":"Division of Liver and Gastrointestinal Transplant, Department of Surgery University of Miami Miller School of Medicine Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taizo","family":"Hibi","sequence":"additional","affiliation":[{"name":"Division of Liver and Gastrointestinal Transplant, Department of Surgery University of Miami Miller School of Medicine Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Ernesto A.","family":"Pretto","sequence":"additional","affiliation":[{"name":"Division of Solid Organ Transplantation, Department of Anesthesiology, Perioperative Medicine and Pain Management University of Miami Miller School of Medicine Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,5,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21381"},{"key":"e_1_2_7_3_1","first-page":"54","article-title":"Postreperfusion syndrome: cardiovascular collapse following hepatic reperfusion during liver transplantation","volume":"19","author":"Aggarwal S","year":"1987","journal-title":"Transpl Proc"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.12659\/AOT.881861"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2011.12.010"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aia.0000210816.08158.63"},{"key":"e_1_2_7_7_1","first-page":"659","article-title":"Homotransplantation of the liver in humans","volume":"117","author":"Starzl TE","year":"1963","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_7_8_1","first-page":"102","article-title":"Orthotopic liver transplantation with the assistance of an external shunt and a nonpulsatile perfusion pump","volume":"35","author":"Toledo\u2010Pereyra LH","year":"1983","journal-title":"Transplantation"},{"key":"e_1_2_7_9_1","first-page":"3500","article-title":"Hemodynamic changes on clamping and unclamping of major vessels during liver transplantation","volume":"21","author":"Estrin JA","year":"1989","journal-title":"Transpl Proc"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(99)00227-6"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.20794"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2010.02.072"},{"key":"e_1_2_7_13_1","first-page":"251656","article-title":"Contemporaneous portal\u2010arterial reperfusion during liver transplantation: preliminary results","volume":"2011","author":"Adani GL","year":"2011","journal-title":"J Transpl"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840210112"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2006.00347.x"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2003.tb00232.x"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2004.00231.x"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199702150-00012"},{"key":"e_1_2_7_19_1","first-page":"CD007512","article-title":"Techniques of flushing and reperfusion for liver transplantation","volume":"3","author":"Gurusamy KS","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/13651820500542135"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01242.x"},{"key":"e_1_2_7_22_1","unstructured":"Organ Distribution: Allocation of Livershttp:\/\/optn.transplant.hrsa.gov\/PoliciesandBylaws2\/policies\/pdfs\/policy_8.pdf Accessed July 11 2011."},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198311000-00010"},{"key":"e_1_2_7_24_1","unstructured":"PSMATCH2: Stata module to perform full Mahalanobis and propensity score matching common support graphing and covariate imbalance testing http:\/\/ideas.repec.org\/c\/boc\/bocode\/s432001.html Accessed June 6 2012."},{"key":"e_1_2_7_25_1","first-page":"185","article-title":"Cardiac arrest after graft reperfusion during liver transplantation","volume":"5","author":"Shi XY","year":"2006","journal-title":"Hepatobiliary Pancreat Dis Int"},{"key":"e_1_2_7_26_1","first-page":"1912","article-title":"Reperfusion injury of the liver","volume":"23","author":"Pretto EA","year":"1991","journal-title":"Transpl Proc"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199304000-00024"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199205000-00001"},{"key":"e_1_2_7_29_1","first-page":"1342","article-title":"Clinical results in liver transplantation using UW solution for extended preservation","volume":"21","author":"Kalayoglu M","year":"1989","journal-title":"Transpl Proc"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1989.03420050061039"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199108000-00008"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199105000-00005"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840100307"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02899106"},{"key":"e_1_2_7_35_1","first-page":"83","article-title":"Kupffer cell activation and endothelial cell damage after storage of rat livers: effects of reperfusion","volume":"13","author":"Caldwell\u2010Kenkel JC","year":"1991","journal-title":"Hepatology"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199003000-00002"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199007000-00003"},{"key":"e_1_2_7_38_1","first-page":"2980","article-title":"Postischemic hepatic lipid peroxidation, monitored by chemiluminescence, depends on duration of ischemia","volume":"28","author":"Zar HA","year":"1996","journal-title":"Transpl Proc"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.22227"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-005-1081-1"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000152800.19986.9E"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)81196-1"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840170413"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840100412"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840150122"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2008.06.035"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365597609179653"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.1996.tb00989.x"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200203150-00008"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1042\/bj1010284"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.4.3.173"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199403270-00004"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-4804(72)90099-6"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.168.3934.977"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199109000-00005"},{"key":"e_1_2_7_56_1","first-page":"541","article-title":"Flushing with autologous blood improves intraoperative hemodynamic stability and early graft function in clinical hepatic transplantation","volume":"178","author":"Fukuzawa K","year":"1994","journal-title":"J Am Coll Surg"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.500030106"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fctr.12130","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.12130","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T17:09:43Z","timestamp":1696352983000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.12130"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5,9]]},"references-count":56,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2013,7]]}},"alternative-id":["10.1111\/ctr.12130"],"URL":"https:\/\/doi.org\/10.1111\/ctr.12130","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,5,9]]}}}