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Intra‐operative portal hemodynamics in pediatric LDLT: Doppler ultrasound surveillance
Author(s) -
Gu Lihong,
Fang Hua,
Zhang Shijun,
Chi Jiachang,
Li Fenghua,
Xia Qiang
Publication year - 2018
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13200
Subject(s) - medicine , hemodynamics , anastomosis , doppler ultrasound , ultrasonography , incidence (geometry) , doppler effect , retrospective cohort study , ultrasound , ligation , surgery , cardiology , radiology , physics , astronomy , optics
Doppler ultrasonography is useful in monitoring intra‐operative PV flow in LDLT. A retrospective cohort study included 550 pediatric recipients (<18 years) who underwent LDLT from October 2006 to August 2016 in our hospital. A total of 33 recipients (incidence 6%) were found to have insufficient intra‐operative PV flow after PV reperfusion. The treatments included intra‐operative stent placement (n=25), anticoagulation (n=3), thrombectomy and re‐anastomosis (n=2), graft repositioning (n=1), collateral ligation (n=1), and replaced PV (n=1). The peak PV velocity, HAPSV, HARI, and HV velocity before and after the interventions were significantly improved 0(0,5.5) cm/s vs. 37.36±15.30 cm/s, 38.68±8.92 cm/s vs. 62.30±16.97 cm/s, 0.55±0.08 vs. 0.76±0.10, and 32.37±10.33 cm/s vs. 40.94±15.01 cm/s, respectively ( P <.01). Insufficient PV flow and decreased HARI are two significant criteria indicating need for intra‐operative PV management. Dramatic changes in the hepatic hemodynamics were detected after proper treatment. Immediate resolution of PV flow is feasible in pediatric LDLT.