Document Detail


Intraoperative portal vein blood flow predicts allograft and patient survival following liver transplantation.
MedLine Citation:
PMID:  20590883     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We hypothesized that operative variables might predict survival following liver transplantation.
METHODS: We examined perioperative variables from 469 liver transplants carried out at the University of Washington during 2003-2006. Logistic regression determined the variables' contributions to survival at 30, 90 and 365 days.
RESULTS: Portal vein blood flow (>1 l/min) was significant to patient survival at 30, 90 and 365 days. Complete reperfusion was only a significant predictor of survival at 30 days. This provided model receiver operating characteristic (ROC) area under the curve (AUC) statistics of 0.93 and 0.87 for 30 and 90 days, respectively. At 365 days, hepatic artery blood flow (>250 ml/min) combined with portal vein blood flow was significantly predictive of survival, with an AUC of 0.74. A subset analysis of 110 transplants demonstrated improved 1-year survival with more aggressive vascular revisions.
DISCUSSION: Portal vein blood flow is a significant predictor of survival after liver transplantation. Initially, the liver's survival is based on portal vein blood flow; however, subsequent biliary problems and patient demise result from both poor portal vein and inadequate hepatic artery blood flow.
Authors:
Austin L Spitzer; Andre A S Dick; Ramasamy Bakthavatsalam; Jeffrey B Halldorson; Paolo R Salvalaggio; Jorge D Reyes; James D Perkins
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  HPB : the official journal of the International Hepato Pancreato Biliary Association     Volume:  12     ISSN:  1477-2574     ISO Abbreviation:  HPB (Oxford)     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-07-01     Completed Date:  2010-10-14     Revised Date:  2011-07-27    
Medline Journal Info:
Nlm Unique ID:  100900921     Medline TA:  HPB (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  166-73     Citation Subset:  IM    
Affiliation:
Division of Transplantation, Department of Surgery, University of Washington, Seattle, WA 98195-6410, USA. spitz@u.washington.edu
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MeSH Terms
Descriptor/Qualifier:
Blood Flow Velocity
Female
Graft Survival*
Hepatic Artery
Humans
Intraoperative Period
Liver Circulation*
Liver Transplantation / mortality*
Male
Middle Aged
Portal Vein*
ROC Curve
Reperfusion
Retrospective Studies
Time Factors
Transplantation, Homologous
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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