Avaliação clínica de pacientes submetidos a transplante hepático pela técnica de bypass no Hospital Geral de Goiânia

Abstract

Introduction: Liver transplantation requires rigorous hemodynamic stability during the anhepatic phase. The use of veno-venous bypass (VVB) aims to mitigate systemic and portal congestion, protecting renal function and optimizing survival, although its actual impact remains debated. Objective: To analyze the association between veno-venous bypass, the occurrence of acute kidney injury (AKI), and overall survival in liver transplant recipients. Methodology: Retrospective cohort study of 63 patients, analyzed using Python 3.13.5. AKI was defined by KDIGO criteria (D1–D3). Survival was assessed by Kaplan-Meier curves and mortality risk by multivariate Cox regression, adjusted for MELD, ischemia time, and etiology. Results: The groups (With VVB: n=37; Without VVB: n=26) showed homogeneous demographic and etiological profiles (p>0,05). VVB use was not independently associated with AKI reduction (OR 0.63; p=0,679) or increased overall survival (p=0,758). Hepatocellular carcinoma (HCC) in the explant emerged as a significant protective predictor for survival (HR 0.06; p=0.020). Total ischemia time and portal hypertension showed clinical trends but no statistical significance after adjustment. Conclusion: Veno-venous bypass proved to be a safe perioperative support technique; however, it did not act as an independent determinant of overall survival or early renal function. Post-transplant prognosis in this cohort was primarily governed by biological factors and the underlying diagnosis (HCC), prevailing over the venous bypass technique employed.