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Splanchnic hyperemia after liver transplantation in patients with end‐stage liver disease
Author(s) -
Alvarez Daniel,
Gerona Solange,
Waisburg Zulema,
Ciardullo Miguel,
Santibañes Eduardo de,
Mastai, Ricardo
Publication year - 1998
Publication title -
liver transplantation and surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1074-3022
DOI - 10.1002/lt.500040403
Subject(s) - medicine , hemodynamics , vascular resistance , cardiac index , liver transplantation , splanchnic , transplantation , cirrhosis , cardiac output , portal hypertension , cardiology , blood flow , liver disease , mean arterial pressure , blood pressure , heart rate
Systemic and splanchnic hemodynamic parameters were evaluated in 12 patients with cirrhosis before and 3 and 6 months after liver transplantation. Results were compared with those obtained in 8 healthy subjects. Three months after liver transplantation recipients had an increase in mean arterial pressure (98 ± 7 v 78 ± 9 mmHg; P < .05), an insignificant decrease in cardiac index (3.4 ± 0.6 v 4.0 ± 1.0 L · min −1 · m −2 ), and a marked increase in peripheral vascular resistance (1,563 ± 308 v 800 ± 205 dyne · s · cm −5 ; P < .05) compared with pretransplantation values. Portal blood flow was also significantly increased (1,494 ± 200 v 829 ± 130 mL/min; P < .05). These hemodynamic changes were more pronounced 6 months after transplantation (mean arterial pressure, 100 ± 8 mmHg; cardiac index, 3.0 ± 1.0 L · min −1 · m −2 ; P < .01; peripheral vascular resistance, 1,680 ± 405 dyne · s · cm −5 ; portal blood flow, 1,520 ± 180 mL/min). Systemic hemodynamics 6 months after liver transplantation were similar to those observed in the healthy control group (mean arterial pressure, 95 ± 6 mmHg; cardiac index, 2.9 ± 0.9 L · min −1 · m −2 ; peripheral vascular resistance, 1,480 ± 380 dyne · s · cm −5 ). However, portal blood flow was still significantly higher than in healthy controls at 6 months (1,520 ± 180 v 910 ± 140 mL/min; P < .05). This study shows that systemic hemodynamics are normalized after liver transplantation. However, an increase in portal blood flow occurs and persists for at least 6 months after liver transplantation. Further studies are needed to clarify the cause of the abnormally high portal flows.