Document Detail


Importance of temporary portocaval shunt during adult living donor liver transplantation.
MedLine Citation:
PMID:  23055401     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Adult Living donor liver transplantation (aLDLT) is associated to surgical risk in the donor and the possibility of development of small-for-size syndrome (SFSS) in the recipient, both events being of great importance. An excessively small liver graft entails a relative increase in portal blood flow during reperfusion, a factor that predisposes to increased risk of SFSS in the postoperative period, although other causes, related to recipient, graft or technical factors have also been reported. Hemodynamic monitoring protocol was used in 45 consecutive aLDLT recipients. After analyzing various hemodynamic parameters before reperfusion, a significant correlation between temporary portocaval shunt flow during the anhepatic phase and portal vein flow (PVF) after reperfusion of the graft (R(2) =0.3, p <0.001) was found, as well as a correlation between the native liver portal pressure (PP) and PVF after reperfusion (R(2) =0.21, p=0.007). Identification of patients at risk for excessive portal hyperflow will allow its modulation prior to reperfusion. This could favor the use of smaller grafts and ultimately a reduction in donor complications by allowing more limited hepatectomies to be performed. © 2012 American Association for the Study of Liver Diseases.
Authors:
S Sánchez Cabús; C Fondevila; D Calatayud; J Ferrer; P Taurá; J Fuster; Jc García-Valdecasas
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-11
Journal Detail:
Title:  Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society     Volume:  -     ISSN:  1527-6473     ISO Abbreviation:  Liver Transpl.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100909185     Medline TA:  Liver Transpl     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 American Association for the Study of Liver Diseases.
Affiliation:
Hepatobiliary Surgery and Liver Transplantation Unit, Hospital Clínic de Barcelona.
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