To analyze the application effect of multimodal warming in the perioperative period of liver transplantation and its impact on early postoperative complications.

Patients who underwent liver transplantation at Affiliated Jinling Hospital, Medical School of Nanjing University from September 1, 2019 to January 31, 2025 were selected as observation subjects. They were divided into the conventional warming group and the multimodal warming group, using the implementation time of multimodal insulation regulations as the demarcation point. A total of 150 pairs of recipients were matched using a 1 ∶1 propensity score matching method. Perioperative temperature data and prognosis-related data of liver transplant recipients were collected, and the duration of intraoperative hypothermia, severity of hypothermia, and postoperative complications between the two groups were compared. Normally distributed measurement data were expressed as mean±standard deviation (±s), and comparisons between groups were performed using independent-samples t-test. Non-normally distributed measurement data were presented as median (interquartile range) [M(P₂₅, P₇₅)], and Mann-Whitney U test was used for inter-group comparison. Count data were expressed as number (percentage), and comparisons between groups were conducted using the χ² test or Fisher′s exact probability test. A P value <0.05 was considered statistically significant.

The incidence of hypothermia in the multimodal warming group was 42.7% (64/150), with a cumulative time of (22.3±8.4) min and a cumulative area of (4.5±2.3) ℃·min, all of which were lower than those in the conventional warming group [65.3% (98/150), (29.6±10.0) min, (5.8 ± 2.7) ℃·min] (χ²=15.152, t=6.844 and 4.771, all P<0.05). The body temperature of the multimodal warming group during hepatic portal occlusion was (36.2±0.3) ℃, and (35.6±0.6) ℃ at 5 min after inferior vena cava recanalization, both higher than those in the conventional warming group [(36.1±0.3) ℃ and (35.2±0.6) ℃, t=-2.459 and -4.955, all P<0.05]. The multimodal warming group also showed significantly lower intraoperative bleeding [1 600 (1 250, 2 190) vs 1 870 (1 300, 2 600) mL, Z=-2.508, P< 0.05], plasma transfusion [900 (700, 1 300) vs 1 000 (800, 1 600) mL, Z=-2.303, P<0.05], incidence of reperfusion syndrome [22.7% vs 35.3%, χ²=5.844, P<0.05], and a shorter postoperative time to extubation of tracheal tube [3(2, 9) vs 7(3, 13) h, Z=-4.110, P<0.05].

Multimodal warming technology can reduce the incidence and duration of intraoperative hypothermia in liver transplantation, decrease intraoperative bleeding and blood product requirements, lower the incidence of postoperative complications, and shorten the time of postoperative extubation, which promotes the rapid recovery of liver transplant recipients.