Background and Goal of Study: . 
Liver transplantation (LT) is associated with high rate of postoperative complications. Although recent studies have demonstrated that an increase of perioperative biomarkers of myocardial injury such as troponin T (TnT) is related with poor postoperative outcome, there are no studies analyzing intraoperative values of such markers in the population of liver transplant recipients. The goal of our study was to investigate what is the impact of intraoperative elevation of TnT on early postoperative course after liver transplantation. 
Materials and methods: 
184 adult patients undergoing LT were enrolled in the study. Patients undergoing retransplantation and those with elevated basal troponins were excluded. Anesthesia delivery and monitoring according to the hospital protocol included analysis of cardiac biomarkers such as high-sensitivity troponin T (HS-TnT) and hemodynamic measurements with PiCCO2 (Pulsion Medical Systems) in at least 3 key moments of the surgery (hepatic disection, anhepatic phase and after graft implantation). 
Troponin level above 42 ng/L is considered highly suggestive of underlying myocardial injury in our center. Patients were divided into 2 groups according to HS-TnT level above or below 42 ng/L measured 60 minutes after graft reperfusion and its association with poorer immediate postoperative outcomes was analyzed retrospectively. Statistical study was performed with U-Mann-Whitney.
Results and discussion: 
33.8% of patients presented HS-TnT >42 ng/L at 60 minutes after graft reperfusion. No clinical findings suggesting myocardial injury were found in the intraoperative and early postoperative course (Cardiac Index, CFI and ECGs showed no significant changes). Postoperative mechanical ventilation and ICU stay were prolonged in the group of patients with elevated troponin level and it was clinically and statistically significant.



Conclusions: 
Troponin elevation during liver transplantation predicts early complicated postoperative course. It seems to have a relevant prognostic value enabling prediction of clinical deterioration before other measurable derangements occur and allows for earlier adaptation of anaesthetic management to patient individual requirements.

The impact of high-sensitive troponin levels during liver transplantation on postoperative course: preliminary results