P-86 MELD SCORE AND EARLY EXTUBATION IN THE INTENSIVE CARE UNIT AFTER LIVER TRANSPLANTATION: 20 YEARS EXPERIENCE IN A SINGLE CENTER IN PERU

Introduction

Liver transplantation (LTx) is an effective therapy and is the only definitive treatment for acute and chronic liver diseases in selected patients. Time on mechanical ventilation and early extubation after liver transplantation (LTx) influences in morbidity and mortality and is a prognostic factor for early complications after transplantation.

Objectives

To show the MELD score and the tracheal extubation time in the immediate postoperative period after liver transplantation.

Methods

Descriptive, retrospective study. The medical records of 209 adult liver transplant patients were reviewed, carried out from March 23, 2000 to November 30, 2020, treated in the Intensive Care Unit (ICU) by the Transplant team at the Guillermo Almenara National Hospital in Lima, Peru. Inclusion criteria: adults over 18 years old, exclusion criteria: under 18 years old, fast track in the operating room, double transplant, SPLIT, Domino technique.

Results

In 146 of 209 patients (69.9%) we performed successful tracheal extubation < 1 day: 31 patients (14.8%), 1-3 days, 26 patients (12.4%) 4-7 days, > 7 days:(0.47%). The MELD score did not have any impact in the time of tracheal extubation in ICU in the diferents groups In our study.

Conclusions

In our experience, 69.9% of the patients were successful extubated on the first day after liver transplantation. There were no differences between the tracheal extubation time and MELD score in our patients. There is a trend to reduce mechanical ventilation time after liver transplantation to facilitate early discharge from the ICU, reducing costs and optimizing resources. Our experience shows that early post-transplant extubation is safe, optimizing available resources.