Post Reperfusion Syndrome In Living Donor Liver Transplantation: Incidence, Predictors, and Impact on Early Allograft Dysfunction and Patient Outcomes

Liver transplantation represents one of the most complex and resource-intensive surgical interventions in modern medicine, undertaken in patients with advanced liver disease and significant hemodynamic compromise. Despite improvements in surgical techniques, anesthesia, and perioperative care, intraoperative and early postoperative complications remain major determinants of graft and patient survival. Among these, Post Reperfusion Syndrome (PRS) and Early Allograft Dysfunction (EAD) are of particular concern, as they directly influence hemodynamic stability, graft viability, and long-term outcomes Post Reperfusion Syndrome (PRS) and Early Allograft Dysfunction (EAD), though temporally distinct, are mechanistically intertwined. The hemodynamic instability, ischemia-reperfusion injury, and metabolic insults characteristic of PRS can compromise graft function, creating a substrate for EAD in the postoperative period. Understanding their shared and independent risk factors, pathophysiology, and implications is essential for improving patient optimisation, intraoperative management, and postoperative care in liver transplantation. In this study we will be evaluating the contribution of PRS on the functioning of the graft in the postoperative period to correlate intraoperative PRS with postoperative EAD, helping identify modifiable risk factors to improve patient outcomes.