Analysis of hepatic and renal dysfunction after surgery of thoracic aneurysm

: To analyze causes of postoperative hepatic and renal dysfunction in patients with thoracic aneurysm, we examined 31 patients who survived surgeries and 2 patients died of MOF. The patients were separated into three groups as follows; Cardiopulmonary bypass (CPB) was used for circulatory support in group A (n = 7), CPB and low flow perfusion during open distal anastomosis in group B (n = 13) and temporary bypass or left atrial distal aorta arterial bypass was used in group C (n = 11). Operation time was significantly longer in group A (9.8 hrs) compared with group C (6.1 hrs). Amount of intraoperative blood transfusion was greater in groups A (4980 ml) and B (4860 ml) compared with group C (2320 ml). Postoperative highest total bilirubin level was significantly greater in group A (7.8 mg/dl) than group C (2.5 mg/dl). LDH was higher in groups A (1322 IU/l) and B (1336 IU/l) than group C (991 IU/l). GOT was higher in group B (200 IU/l) than group C (64 IU/l). There were no significant differences in GPT, creatinine and BUN among the three groups. Operation time and amount of intraoperative blood transfusion were positively correlated with postoperative hepatic function parameters. Two patients died of MOF showed severe hepato-renal dysfunction associated with LOS. The results indicate that hypothermic low flow perfusion during open distal anastomosis do not induce hepatic or renal dysfunction, and postoperative hyperbilirubinemia is resulted from bilirubin overload which patients can tolerate well if they are not complicated with MOF.