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High cardiac output of advanced liver disease persists after orthotopic liver transplantation
Author(s) -
Henderson J. Michael,
Mackay Gregory J.,
Hooks Michael,
Chezmar Judith L.,
Galloway John R.,
Dodson Thomas F.,
Kutner Michael H.
Publication year - 1992
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840150214
Subject(s) - medicine , cardiac output , transplantation , cardiac function curve , liver transplantation , cirrhosis , hyperdynamic circulation , cardiology , liver disease , blood pressure , portal hypertension , heart failure
This study measured cardiac output before and 1 or 2 yr after orthotopic liver transplantation in 23 patients. Cardiac output was measured by thermodilution before transplantation and by first‐pass radionuclide angiocardiography at follow‐up. Study patients were selected as those doing well clinically and by standard laboratory tests at 1‐yr and 2‐yr reevaluations with no evidence of rejection: six had mild recurrent hepatitis shown on biopsy samples. Hepatocyte function was normal at the time of the study as shown by galactose elimination capacity of 442 ± 90 mg/min. Medications were cyclosporine and prednisone in all patients, azathioprine in 10 patients and a combination of antihypertensive therapy to maintain diastolic blood pressure less than 90 mm Hg in 20 patients. Mean (± S.D.) pretransplantation cardiac output was 9.1 ± 3.1 L/min and remained elevated at 8.3 ± 2.1 L/min 1 yr, and 9.6 ± 2.6 L/min (n = 13) 2 yr after transplantation. A significant (p < 0.001) correlation was found between pretransplant and follow‐up cardiac output. End diastolic, end systolic and stroke volumes are all increased in a pattern similar to that seen in end‐stage cirrhosis. These data show that the high cardiac output of the hyperdynamic state of advanced liver disease persists after liver transplantation. The mechanisms and consequences of this require further study.