Document Detail

Impact of portal venous pressure on regeneration and graft damage after living-donor liver transplantation.
MedLine Citation:
PMID:  15690538     Owner:  NLM     Status:  MEDLINE    
Several reports claim that portal hypertension after living-donor liver transplantation (LDLT) adversely affects graft function, but few have assessed the impact of portal venous pressure (PVP) on graft regeneration. We divided 32 adult LDLT recipients based on mean PVP during the 1st 3 days after LDLT into a group with a PVP > or = 20 mm of Hg (H Group; n = 17), and a group with a PVP < 20 mm of Hg (L Group; n = 15). Outcome in the H Group was poorer than in the L Group (58.8 vs. 92.9% at 1 year). Peak peripheral hepatocyte growth factor (HGF) during the 1st 2 weeks was higher in the H Group (L: 1,730 pg/mL, H: 3,696 pg/mL; P < .01), whereas peak portal vascular endothelial growth factor (VEGF) level during the 1st week was higher in the L Group (L: 433 pg/mL, H: 92 pg/mL; P < .05). Graft volume (GV) / standard liver volume (SLV) was higher in the H Group (L / H, at 2, 3, and 4 weeks, and at 3 months: 1.02 / 1.24, .916 / 1.16, .98 / 1.27, and .94 / 1.29, respectively; P < .05). Peak serum aspartate aminotransferase, bilirubin levels, and international normalized ratio after LDLT were significantly higher in the H Group, as was mean ascitic fluid volume. In conclusion, early postoperative PVP elevation to 20 mm of Hg or more was associated with rapid graft hypertrophy, higher peripheral blood HGF levels, and lower portal VEGF levels; and with a poor outcome, graft dysfunction with hyperbilirubinemia, coagulopathy, and severe ascites. Adequate liver regeneration requires an adequate increase in portal venous pressure and flow reflected by clearance of HGF and elevated VEGF levels.
Shintaro Yagi; Taku Iida; Kentaro Taniguchi; Tomohide Hori; Takashi Hamada; Koji Fujii; Shugo Mizuno; Shinji Uemoto
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society     Volume:  11     ISSN:  1527-6465     ISO Abbreviation:  Liver Transpl.     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-02-03     Completed Date:  2005-04-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100909185     Medline TA:  Liver Transpl     Country:  United States    
Other Details:
Languages:  eng     Pagination:  68-75     Citation Subset:  IM    
First Department of Surgery, Mie University School of Medicine, 2-174, Edobashi, Tsu City, Mie Prefecture, 514-8507, Japan.
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MeSH Terms
Alanine Transaminase / blood
Aspartate Aminotransferases / blood
Bilirubin / blood
Blood Pressure
Graft Survival / physiology
Hypertension, Portal / physiopathology*
Liver Diseases / physiopathology,  surgery
Liver Regeneration / physiology*
Liver Transplantation*
Living Donors*
Middle Aged
Portal Vein / physiology*
Retrospective Studies
Reg. No./Substance:
635-65-4/Bilirubin; EC Aminotransferases; EC Transaminase

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

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