Hepatic hemodynamic changes during liver transplantation: A review

Feng, An‐Chieh; Fan, Huiying; Chen, Teng-Wei; Hsieh, Chung-Bao

doi:10.3748/wjg.v20.i32.11131

Cited by 50 publications

(39 citation statements)

References 67 publications

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“…The present study did not reveal the mechanism or clinical benefit of managing PVR during LT. Moreover, there is no consensus on the optimal hemodynamic management during LT . Because of these limitations, the results of this study are not confirmative.…”

Section: Discussioncontrasting

confidence: 57%

Predictive Value of Intraoperative Pulmonary Vascular Resistance in Liver Transplantation

et al. 2018

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We aimed to evaluate the association between intraoperative pulmonary vascular resistance (PVR) and clinical outcome of liver transplantation (LT). Cardiovascular involvement of end-stage liver disease is relatively common, and hemodynamic instability during LT can be fatal to recipients. However, the clinical impact of intraoperative PVR in LT remains undetermined. A total of 363 adult recipients with intraoperative right heart catheterization fromJanuary 2011 to May 2016 were analyzed. Patients were divided into 2 groups according to PVR. Two separate analyses were performed according to the time point of measurement: at the beginning and at the end of LT. The primary outcome was all-cause death or graft failure during the follow-up period. Increased PVR was observed in 11.8% (43/363) of recipients at the beginning and 12.7% (46/363) of recipients at the end of LT. PVR at the beginning of LT had no significant effect on the rate of death or graft failure in the multivariate analysis (hazard ratio [HR], 1.24; 95% confidence interval [CI], 0.64-2.38; P = 0.52). In contrast, PVR at the end of LT was significantly associated with death or graft failure during the overall follow -up period (HR, 2.00; 95% CI, 1.13-3.54; P = 0.02). In conclusion, PVR at the end of LT, rather than the beginning, is associated with clinical outcome. Larger trials are needed to support this finding.

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Section: Discussioncontrasting

confidence: 57%

Predictive Value of Intraoperative Pulmonary Vascular Resistance in Liver Transplantation

et al. 2018

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“…). The shunt diameter was kept to a smaller size than that of the main portal vein, with an aim to keep the shunt flow at about a third to half of the hepatic portal venous flow to avoid the portal steal phenomenon . The mean PV diameter was 14.3 ± 3.1 mm (range, 10.5‐21.2 mm), and mean HPCS diameter was 9.2 ± 1.3 mm (range, 5.3‐11.1 mm).…”

Section: Methodsmentioning

confidence: 99%

Is Portal Inflow Modulation Always Necessary for Successful Utilization of Small Volume Living Donor Liver Grafts?

et al. 2019

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Although the well‐accepted lower limit of the graft‐to‐recipient weight ratio (GRWR) for successful living donor liver transplantation (LDLT) remains 0.80%, many believe grafts with lower GRWR may suffice with portal inflow modulation (PIM), resulting in equally good recipient outcomes. This study was done to evaluate the outcomes of LDLT with small‐for‐size grafts (GRWR <0.80%). Of 1321 consecutive adult LDLTs from January 2012 to December 2017, 287 (21.7%) had GRWR <0.80%. PIM was performed (hemiportocaval shunt [HPCS], n = 109; splenic artery ligation [SAL], n = 14) in 42.9% patients. No PIM was done if portal pressure (PP) in the dissection phase was <16 mm Hg. Mean age of the cohort was 49.3 ± 9.1 years. Median Model for End‐Stage Liver Disease score was 14, and the lowest GRWR was 0.54%. A total of 72 recipients had a GRWR <0.70%, of whom 58 underwent HPCS (1 of whom underwent HPCS + SAL) and 14 underwent no PIM, whereas 215 had GRWR between 0.70% and 0.79%, of whom 51 and 14 underwent HPCS and SAL, respectively. During the same period, 1034 had GRWR ≥0.80% and did not undergo PIM. Small‐for‐size syndrome developed in 2.8% patients. Three patients needed shunt closure at 1 and 4 weeks and 60 months. The 1‐year patient survival rates were comparable. In conclusion, with PIM protocol that optimizes postperfusion PP, low‐GRWR grafts can be used for appropriately selected LDLT recipients with acceptable outcomes.

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“…In Figure 4.2b, visible abnormalities were the tightening of central venous, irregular parenchymal cell structure and picnotic in cell nucleus. Inflammation or abnormalities on liver began on central venous blood as blood reservoir that comes from the hepatic artery and portal vein [20]. Central venous narrowing might be due to the blockage on blood vessels that carry blood from the rest of the body, caused by the presence of toxic or metal that accumulates in the body.…”

Section: Histological Structure Of the Livermentioning

confidence: 99%

The Effect of Sappan Wood Extract (Caesalpinia sappan), Wheat grass and Vitamin E Treatment on the Liver Structure of Iron overload of Rat (Rattus norvegicus)

Safitri

Reniarti

Madihah

et al. 2017

KLS

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This research was carried out to detect the effect of Sappan Wood Extract (Caesalpinia sappan), Wheat grass and Vitamin E Treatment on the liver structure of iron overload rat (Rattus norvegicus).The method of experimental used Completely Random Design (CRD in triple repetition. The treatment had been carried out orally. Iron dextran with total dose of 1.5 g kg −1 of body were given to rat on the first, fourth, seventh, ten and thirteenth day. Sappan Wood Extract (Caesalpinia sappan)200 mg kg −1 bw, 400 mg kg −1 bw, Wheat grass extract 100 mg kg −1 bw and Vitamin E 60 mg kg −1 bw were given to rat everyday for 15 days. At the seventeenth, rat were killed and their liver were taken. The observed parameters are morphological abnormality including the colour, the contour, ratio between liver weight and body weight as well as histological destruction. The result showed iron dextran treatment was proved the abnormality on morphological and histological desruction. Futhermore, Sappan Wood Extract (Caesalpinia sappan), Wheat grass and Vitamin E Treatment can decrease the morphological abnormality and the liver histological destructionon of iron overload rat.

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Hepatic hemodynamic changes during liver transplantation: A review

Cited by 50 publications

References 67 publications

Predictive Value of Intraoperative Pulmonary Vascular Resistance in Liver Transplantation

Predictive Value of Intraoperative Pulmonary Vascular Resistance in Liver Transplantation

Is Portal Inflow Modulation Always Necessary for Successful Utilization of Small Volume Living Donor Liver Grafts?

The Effect of Sappan Wood Extract (Caesalpinia sappan), Wheat grass and Vitamin E Treatment on the Liver Structure of Iron overload of Rat (Rattus norvegicus)

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