Perspective of intra-abdominal hypertension and abdominal compartment syndrome in liver transplantation: A systematic review

Abstract

Introduction: In the postoperative period of liver transplantation there may be an increase in volume contained in the abdomen, massive fluid replacement, intraperitoneal blood accumulation and gastrointestinal distension: these conditions are relevant for Intra-Abdominal Hypertension (HIA) and Abdominal Compartment Syndrome (SCA) development. Evidence on this topic is in progress. The aim of this study was to provide an integrative view of the literature on the prospects for HIA and SCA in liver transplantation. Methods: A systematic search was carried out on MEDLINE (via PubMed), Scielo, LILACS (via BVS) and Cochrane on July 24, 2019. The works were selected by inclusion and exclusion criteria proposed according to the purpose of this review, and were divided in five categories: prevalence, risk factors, monitoring, complications and management. Discussion: HIA and ACS are frequent complications, which can determine an increase in morbidity and mortality in post-liver transplantation. There are several risk factors inherent to the procedure to the development of these conditions, and therefore, it should be actively monitored through the IAP measured by a bladder catheter. HIA is an independent factor for acute renal failure, and it can contribute to the impairing of liver perfusion. Conclusion: Measures for the HIA and ACS control and prevention should be taken in the immediate postoperative period, including both clinical and surgical methods. Maintenance of open abdomen and decompressive laparotomy stand out in this scenario.