Open AccessContrast‐Based Real‐Time Assessment of Microcirculatory Changes in a Fatty Liver After Ischemia Reperfusion Injury
Author(s) -
Kolachala Vasantha L.,
Jiang Rong,
Abramowsky Carlos R.,
Gupta Nitika A.
Publication year - 2016
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000001008
Subject(s) - medicine , microcirculation , liver transplantation , fatty liver , blood flow , hemodynamics , perfusion , ischemia , reperfusion injury , contrast enhanced ultrasound , transplantation , cardiology , pathology , ultrasound , radiology , disease
Objectives: A fatty liver is known to have impairment of microcirculation, which is worsened after ischemia reperfusion injury (IRI). This makes most fatty grafts unsuitable for transplantation, and in the absence of real time assessment of microcirculation this selection has been at best, random. The aim of this study was to demonstrate the utility of a contrast enhanced ultrasound model in quantitative assessment of the microcirculation of a fatty liver. Methods: We subjected fatty mice to IRI, and blood flow dynamics were assessed before and after the injury. Results: There was a significant increase in the resistive and pulsatility index of the extrahepatic artery and a significant decrease in velocity of the portal vein. There was also a quantifiable decrease in the intrahepatic blood volume, blood flow, time to peak flow, and perfusion index of mice with fatty liver, suggesting that a fatty liver develops hemodynamic abnormalities after IRI, leading to increased hepatocellular injury. Conclusions: Hemodynamic abnormalities in liver can be reliably quantified using a contrast, enhanced Doppler ultrasound, which is an inexpensive technique with multiple clinical applications. It can be used to assess the quality of the fatty liver donor graft before organ retrieval; for determining live donor candidacy, for making post‐IRI recovery prognosis, and for assessing the effectiveness of therapeutic interventions.