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Prospective evaluation of intraoperative hemodynamics in liver transplantation with whole, partial and DCD grafts

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Abstract
The interaction of systemic hemodynamics with hepatic flows at the time of liver transplantation (LT) has not been studied in a prospective uniform way for different types of grafts. We prospectively evaluated intraoperative hemodynamics of 103 whole and partial LT. Liver graft hemodynamics were measured using the ultrasound transit time method to obtain portal (PVF) and arterial (HAF) hepatic flow. Measurements were recorded on the native liver, the portocaval shunt, following reperfusion and after biliary anastomosis. After LT HAF and PVF do not immediately return to normal values. Increased PVF was observed after graft implantation. Living donor LT showed the highest compliance to portal hyperperfusion. The amount of liver perfusion seemed to be related to the quality of the graft. A positive correlation for HAF, PVF and total hepatic blood flow with cardiac output was found (p = 0.001). Portal hypertension, macrosteatosis > 30%, warm ischemia time and cardiac output, independently influence the hepatic flows. These results highlight the role of systemic hemodynamic management in LT to optimize hepatic perfusion, particularly in LDLT and split LT, where the highest flows were registered.
Keywords
portal hypertension, ARTERIAL BUFFER RESPONSE, HEPATIC BLOOD-FLOW, PORTAL-HYPERTENSION, RISK-FACTORS, graft inflow modulation, hepatic artery thrombosis, LDLT, liver flows, liver transplantation, systemic and hepatic hemodynamics, SINGLE-CENTER, LIVING DONORS, HEPATORENAL REFLEX, CONSENSUS WORKSHOP, PORTOPULMONARY HYPERTENSION, HEPATOPULMONARY SYNDROME, DCD

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MLA
SAINZ-BARRIGA, MAURICIO, et al. “Prospective Evaluation of Intraoperative Hemodynamics in Liver Transplantation with Whole, Partial and DCD Grafts.” AMERICAN JOURNAL OF TRANSPLANTATION, vol. 10, no. 8, 2010, pp. 1850–60, doi:10.1111/j.1600-6143.2010.03207.x.
APA
SAINZ-BARRIGA, M., REYNTJENS, K., Costa, M., Scudeller, L., Rogiers, X., Wouters, P., … Troisi, R. (2010). Prospective evaluation of intraoperative hemodynamics in liver transplantation with whole, partial and DCD grafts. AMERICAN JOURNAL OF TRANSPLANTATION, 10(8), 1850–1860. https://doi.org/10.1111/j.1600-6143.2010.03207.x
Chicago author-date
SAINZ-BARRIGA, MAURICIO, KOEN REYNTJENS, MG Costa, L Scudeller, Xavier Rogiers, Patrick Wouters, Bernard de Hemptinne, and Roberto Troisi. 2010. “Prospective Evaluation of Intraoperative Hemodynamics in Liver Transplantation with Whole, Partial and DCD Grafts.” AMERICAN JOURNAL OF TRANSPLANTATION 10 (8): 1850–60. https://doi.org/10.1111/j.1600-6143.2010.03207.x.
Chicago author-date (all authors)
SAINZ-BARRIGA, MAURICIO, KOEN REYNTJENS, MG Costa, L Scudeller, Xavier Rogiers, Patrick Wouters, Bernard de Hemptinne, and Roberto Troisi. 2010. “Prospective Evaluation of Intraoperative Hemodynamics in Liver Transplantation with Whole, Partial and DCD Grafts.” AMERICAN JOURNAL OF TRANSPLANTATION 10 (8): 1850–1860. doi:10.1111/j.1600-6143.2010.03207.x.
Vancouver
1.
SAINZ-BARRIGA M, REYNTJENS K, Costa M, Scudeller L, Rogiers X, Wouters P, et al. Prospective evaluation of intraoperative hemodynamics in liver transplantation with whole, partial and DCD grafts. AMERICAN JOURNAL OF TRANSPLANTATION. 2010;10(8):1850–60.
IEEE
[1]
M. SAINZ-BARRIGA et al., “Prospective evaluation of intraoperative hemodynamics in liver transplantation with whole, partial and DCD grafts,” AMERICAN JOURNAL OF TRANSPLANTATION, vol. 10, no. 8, pp. 1850–1860, 2010.
@article{1030720,
  abstract     = {{The interaction of systemic hemodynamics with hepatic flows at the time of liver transplantation (LT) has not been studied in a prospective uniform way for different types of grafts. We prospectively evaluated intraoperative hemodynamics of 103 whole and partial LT. Liver graft hemodynamics were measured using the ultrasound transit time method to obtain portal (PVF) and arterial (HAF) hepatic flow. Measurements were recorded on the native liver, the portocaval shunt, following reperfusion and after biliary anastomosis. After LT HAF and PVF do not immediately return to normal values. Increased PVF was observed after graft implantation. Living donor LT showed the highest compliance to portal hyperperfusion. The amount of liver perfusion seemed to be related to the quality of the graft. A positive correlation for HAF, PVF and total hepatic blood flow with cardiac output was found (p = 0.001). Portal hypertension, macrosteatosis > 30%, warm ischemia time and cardiac output, independently influence the hepatic flows. These results highlight the role of systemic hemodynamic management in LT to optimize hepatic perfusion, particularly in LDLT and split LT, where the highest flows were registered.}},
  author       = {{SAINZ-BARRIGA, MAURICIO and REYNTJENS, KOEN and Costa, MG and Scudeller, L and Rogiers, Xavier and Wouters, Patrick and de Hemptinne, Bernard and Troisi, Roberto}},
  issn         = {{1600-6135}},
  journal      = {{AMERICAN JOURNAL OF TRANSPLANTATION}},
  keywords     = {{portal hypertension,ARTERIAL BUFFER RESPONSE,HEPATIC BLOOD-FLOW,PORTAL-HYPERTENSION,RISK-FACTORS,graft inflow modulation,hepatic artery thrombosis,LDLT,liver flows,liver transplantation,systemic and hepatic hemodynamics,SINGLE-CENTER,LIVING DONORS,HEPATORENAL REFLEX,CONSENSUS WORKSHOP,PORTOPULMONARY HYPERTENSION,HEPATOPULMONARY SYNDROME,DCD}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{1850--1860}},
  title        = {{Prospective evaluation of intraoperative hemodynamics in liver transplantation with whole, partial and DCD grafts}},
  url          = {{http://doi.org/10.1111/j.1600-6143.2010.03207.x}},
  volume       = {{10}},
  year         = {{2010}},
}

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