Hypoxia among patients on the liver-transplant waiting list

Nacif, Lucas Souto; Andraus, Wellington; Sartori, Kathryn; Benites, Carlos Marlon; Santos, Vinicius Rocha; Rocha-Filho, Joel Avancini; D'Albuquerque, Luiz Augusto Carneiro

doi:10.1590/s0102-67202014000100014

Cited by 10 publications

(7 citation statements)

References 10 publications

(17 reference statements)

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“…The hepatic qBOLD assessment may better characterize hepatic mitochondrial function, and thus organ viability, than hepatic blood flow alone for the early detection of liver graft rejection. This hepatic qBOLD approach also enables the evaluation of hypoxemia severity in patients on the liver transplant waiting list …”

Section: Discussionmentioning

confidence: 99%

“…This hepatic qBOLD approach also enables the evaluation of hypoxemia severity in patients on the liver transplant waiting list. 49 It should be noted that, although the estimated hepatic venous blood oxygenation (Y v ) is associated with hepatic oxidative metabolism rate, it does not provide direct quantification of hepatic oxygen extraction fraction, because the upstream blood from the portal vein is partially deoxygenated (~85% during fasting and reduced after food ingestion 3 ). Therefore, additional information including the portal venous oxygenation and the perfusion from the hepatic portal vein and hepatic arteries will be needed to estimate hepatic oxygen extraction/utilization.…”

Section: Discussionmentioning

confidence: 99%

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Mapping hepatic blood oxygenation by quantitative BOLD (qBOLD) MRI

et al. 2019

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Purpose Abnormalities in hepatic oxygen delivery and oxygen consumption may serve as a significant indicator of hepatic cellular dysfunction and may predict treatment response. However, conventional and oxygen‐enhanced hepatic BOLD MRI can only provide semiquantitative assessment of hepatic oxygenation. Methods A hepatic quantitative BOLD (qBOLD) model was proposed for noninvasive mapping of hepatic venous blood oxygen saturation (Yv) and deoxygenated blood volume (DBV) in human subjects. The validity and the estimation bias of the proposed model were evaluated by Monte Carlo simulations. Eight healthy subjects were scanned after written consent with institutional review board approval. Results Monte Carlo simulations demonstrated that the proposed single‐compartment hepatic qBOLD model leads to significant deviation of the predicted T2* decay profile from the simulated signal due to high hepatic blood volume fraction. Small relative estimation bias for hepatic Yv and significant overestimation for hepatic DBV were observed, which can be corrected by applying the calibration curves established from simulations. After correction, the mean hepatic Yv in human subjects was 56.8 ± 6.8%, and the mean hepatic DBV was 0.190 ± 0.035, consistent with measurements from other invasive approaches. Except in regions with significant vascular contamination, the maps for hepatic Yv and DBV were relatively homogenous. Conclusions With estimation bias correction, the hepatic qBOLD approach enables noninvasive mapping of hepatic blood volume and oxygenation in human subjects. The established protocol may be used to quantitatively assess hepatic tissue hypoxia in multiple liver diseases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mapping hepatic blood oxygenation by quantitative BOLD (qBOLD) MRI

et al. 2019

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“…Consequently, LT should be a priority in this patients in the light of the significant survival in properly selected cases that are identified at a stage in which the LT is still feasible, with a postoperative morbidity similar to non-HPS LTs, with the sale level of pre-LT liver disease [10]. According to the current information, the worsening of hypoxemia is progressive and refractory to medical treatment [11]. Several trials have shown a mortality increase in patients with HPS-associated cirrhosis and consequently, LT is suggested as the only effective treatment for this rare but lethal condition [12].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Mortality and Early Detection Strategies for Hepatopulmonary Syndrome in Liver Transplant Patients

Delgado¹,

Cantero²,

Zampella³

et al. 2017

JLRDT

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“…HPS is reported to be present in 4%–32% of adult patients with end‐stage liver disease and in 9%–20% of children. At present, the most effective and only radical treatment is a liver transplant (LT) [8,9]. Interestingly, a previous study revealed that gene polymorphisms correlated with the regulation of angiogenesis were in tight relation to the risk of HPS, and thus further study on the mechanisms how polymorphisms affected the risk of HPS occurrence in certain cirrhosis patients were needed [10].…”

Section: Introductionmentioning

confidence: 99%

Correlations of MMP-2 and MMP-9 gene polymorphisms with the risk of hepatopulmonary syndrome in cirrhotic patients: A case-control study

Liu¹,

Chen²

2018

The Kaohsiung Journal of Medical Sciences

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Hepatopulmonary syndrome (HPS) increases the mortality of patients who suffered from liver cirrhosis, especially patients plagued by severe hypoxemia. Gene polymorphisms are reported to be related to the risk of HPS in cirrhotic patients. Thus, our study aims to elucidate the correlation between MMP‐2 and MMP‐9 gene polymorphisms and HPS in cirrhotic patients. A total of 152 cirrhotic patients suffering from HPS as well as another 152 cirrhotic patients without HPS were recruited. Polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP) was performed for MMP‐2 and MMP‐9 gene polymorphisms and logistic regression analysis for the relationship between clinicopathological features and HPS occurrence in cirrhotic patients. There were significant differences in genotype and allele frequency of MMP‐2 rs243865 and MMP‐9 rs3918242 polymorphisms between the HPS and control groups. CC/CT genotype and C allele of MMP‐2 rs243865 polymorphism as well as CC/TT genotype and T allele of MMP‐9 rs3918242 polymorphism increased the risk of HPS in cirrhotic patients. Genotypes of rs243865 and rs3918242 polymorphisms had remarkable correlations with spider nevi, clubbed fingers (toes), transaminase elevation, portal vein width, esophageal varices, Child‐Pugh classification and partial pressure of arterial oxygen (PaO2). Logistic regression analysis showed that rs243865 and rs3918242 polymorphisms, spider nevi, clubbed fingers (toes), esophageal varices, and Child‐Pugh classification were closely associated with the occurrence of HPS in cirrhotic patients. Our findings demonstrate that MMP‐2 rs243865 polymorphism and MMP‐9 rs3918242 polymorphism can increase the risk of HPS occurrence in cirrhotic patients, which provides a potential target for prevention of HPS in cirrhotic patients.

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Hypoxia among patients on the liver-transplant waiting list

Cited by 10 publications

References 10 publications

Mapping hepatic blood oxygenation by quantitative BOLD (qBOLD) MRI

Mapping hepatic blood oxygenation by quantitative BOLD (qBOLD) MRI

Predictors of Mortality and Early Detection Strategies for Hepatopulmonary Syndrome in Liver Transplant Patients

Correlations of MMP-2 and MMP-9 gene polymorphisms with the risk of hepatopulmonary syndrome in cirrhotic patients: A case-control study

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