Incidence and indications for reintubation during postoperative care following orthotopic liver transplantation

Study Objective: To analyze the incidence and indications for reintubation during Postoperative care following orthotopic liver transplantation (OLT). Design: Retrospective chart review. Setting: Large metropolitan teaching hospital. Patients: 546 adult liver transplant recipients. Measurements and Main Results: The medical charts of 546 patients who under went OLT at our institution between January 1992 and September 1996 were re viewed for the incidence and indications of reintubation throughout primary hospitalization. Eighty-one of 546 patients (14.8 %) required one or more episodes of reintubation after OLT. In the majority of cases, reintubation was performed for pulmonary complications (44.6%), followed by cerebral (19 .1 %) and surgical (14.5%) complications. Cardiac (9.1 %) and peripheral ne urologic (2.7%) complications were less frequent reasons for reintubation. Overall patient survival, according to the Kaplan-Meier estimates, was 89.9 %, 87.5%, 86.5 %, and 82.2 % after 1, 2, 3, and 5 years, respectively. In p atients with one or more episodes of reintubation, overall survival decreas ed to 62.5% after 1, 2, and 3-years, and to 56.4 % after 5 years (p < 0. 00 1). Conclusions: The main indications for reintubation after OLT were pulmonary , cerebral, and surgical complications. These reintubation events had a con siderable influence on the Patient's Postoperative recovery, and were assoc iated with a significantly higher rate of mortality, than for OLT patients who did not undo reintubation. (C) 2001 by Elsevier Science Inc.