Document Detail


Hemodynamic interaction between portal vein and hepatic artery flow in small-for-size split liver transplantation.
MedLine Citation:
PMID:  12122512     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In split-liver transplantation, the entire portal flow is redirected through relatively small-for-size grafts. It has been postulated that excessive portal blood flow leads to graft injury. In order to elucidate the mechanisms of this injury, we studied the hemodynamic interactions between portal vein- and hepatic artery flow in an experimental model in pigs. Six whole pig liver grafts were implanted in Group 1 ( n=6) and six whole liver grafts were split into right and left grafts and transplanted to Groups 2 ( n=6) and 3 ( n=6), respectively. The graft-to-recipient liver volume ratio was 1:1, 2:3 and 1:3 in Groups 1, 2 and 3, respectively. Portal vein- and hepatic artery flows were measured with an ultrasonic flow meter at 60,120 and 180 min after graft reperfusion. Portal vein pressure was also recorded at the same time intervals. Graft function was assessed at 3,6h and 12h, and morphological changes at 12h after reperfusion. Following reperfusion, portal vein flow showed an inverse relationship to graft size, while hepatic artery flow was reduced proportionately to graft size. The difference was significant among the three groups ( P<0.05). Portal vein pressure was significantly higher in group 3, compared to groups 1 and 2 ( P<0.05). Hepatic artery buffer response was significantly higher in Group 3, compared to Groups 1 and 2 in relation to pre-occlusion values ( P<0.05). Split-liver transplantation, when resulting in small-for-size grafts, is associated with portal hypertension, diminished arterial flow, and graft dysfunction. Arterial flow impairment appears to be related to increased portal vein flow.
Authors:
Vassilios Smyrniotis; Georgia Kostopanagiotou; Agathi Kondi; Evangelos Gamaletsos; Kassiani Theodoraki; Dimitrios Kehagias; Kyriaki Mystakidou; John Contis
Publication Detail:
Type:  Journal Article     Date:  2002-06-12
Journal Detail:
Title:  Transplant international : official journal of the European Society for Organ Transplantation     Volume:  15     ISSN:  0934-0874     ISO Abbreviation:  Transpl. Int.     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-17     Completed Date:  2003-02-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8908516     Medline TA:  Transpl Int     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  355-60     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Athens Medical School, Aretaeion Hospital, Athens, Greece. vsmyrniotis@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Animals
Aspartate Aminotransferases / blood
Blood Flow Velocity
Hemodynamics / physiology*
Hepatic Artery / physiology*,  surgery
Liver / anatomy & histology*
Liver Transplantation / methods*,  physiology
Models, Animal
Portal Vein / physiology*,  surgery
Reperfusion
Swine
Time Factors
Transplantation, Homologous
Chemical
Reg. No./Substance:
EC 2.6.1.1/Aspartate Aminotransferases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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