Exploring Portal Vein Hemodynamic Velocities as a Promising, Attractive Horizon for Small-for-Size Syndrome Prediction After Living-Donor Liver Transplantation: An Egyptian Center Study

Salman, Ahmed; El-Garem, Nouman; Sholkamy, Amany; Hosny, Karim Adel; Abdelaziz, Omar

doi:10.1016/j.transproceed.2016.03.051

Cited by 5 publications

(2 citation statements)

References 11 publications

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“…A previous study, conducted at our center in 2014, aimed to correlate the portal hemodynamic changes in the recipients with liver functions. It concluded that the rise in PVP significantly influenced the indices of liver function after LDLT [20].…”

Section: Discussionmentioning

confidence: 99%

Effect of Portal Venous Pressure on Liver Function of Donors in Living Donor Liver Transplantation

et al. 2019

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Background We assessed the alterations in portal hemodynamics associated with donor right hepatectomy and its effects on functional regeneration of the remnant liver. Material/Methods This prospective study included 30 adult living donors who underwent right hepatectomy in the Liver Transplantation Unit, Faculty of Medicine, Cairo University from June 2015 to October 2016. During donor surgery, portal venous pressure (PVP) was measured using an antithrombotic catheter inserted into the main portal vein, and was measured before and after clamping of the right portal vein. Postoperatively, liver function tests were done daily until normalization. The outcome measures were the time to normalization of liver function tests and effect of residual volume and steatosis on PVP. Results All donors had normal PVP before clamping and changed significantly after clamping (p<0.001). After clamping, 25 donors (83%) had a PVP above 12 mmHg; i.e. had high portal pressure. The median percentage of change was 55%. There were obvious increases in liver enzymes and bilirubin after surgery, but albumin and international normalized ratio showed progressive decreases postoperatively. The percent change in PVP was positively correlated with the levels of liver enzymes, time to normalization of liver enzymes, albumin, and bilirubin, and with the degree of steatosis, bit it was negatively correlated with residual liver volume. Conclusions During living donor liver transplantation, PVP increases by over 50% after clamping of the right portal vein of the donor’s liver. This increase is associated with temporary delay of normalization of liver function of the donors.

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Section: Discussionmentioning

confidence: 99%

Effect of Portal Venous Pressure on Liver Function of Donors in Living Donor Liver Transplantation

et al. 2019

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“…All studies included data on the development of SFSS or PHLF (including SFSS), according to whether they were, [16][17][18][19][20][21][22][23] whilst six studies utilised the following; bilirubin >10 mg/dL on postoperative day (POD) 14 alongside intractable ascites (>1000 mls/day on POD14 or >500 mls/day on POD28). 3,15,[24][25][26][27] Three studies used a similar definition with bilirubin >5 mg/ dL 2,28,29 and one study increased the bilirubin cut off to >20 mg/ dL.…”

Section: Primary Outcome -Sfssmentioning

confidence: 99%

A systematic review of small for size syndrome after major hepatectomy and liver transplantation

Riddiough

Christophi

Jones

et al. 2020

HPB

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Background: Major hepatectomy (MH) and particular types of liver transplantation (LT) (reduced size graft, living-donor and split-liver transplantation) lead to a reduction in liver mass. As the portal venous return remains the same it results in a reciprocal and proportionate rise in portal venous pressure potentially resulting in small for size syndrome (SFSS). The aim of this study was to review the incidence, diagnosis and management of SFSS amongst recipients of LT and MH.Methods: A systematic review was performed in accordance with the 2010 Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The following terms were used to search PubMed, Embase and Cochrane Library in July 2019: ("major hepatectomy" or "liver resection" or "liver transplantation") AND ("small for size syndrome" or "post hepatectomy liver failure"). The primary outcome was a diagnosis of SFSS.Results: Twenty-four articles met the inclusion criteria and could be included in this review. In total 2728 patients were included of whom 316 (12%) patients met criteria for SFSS or post hepatectomy liver failure (PHLF). Of these, 31 (10%) fulfilled criteria for PHLF following MH. 8 of these patients developed intractable ascites alongside elevated portal venous pressure following MH indicative of SFSS. Conclusion: SFSS is under-recognised following major hepatectomy and should be considered as an underlying cause of PHLF. Surgical and pharmacological therapies are available to reduce portal congestion and reverse SFSS.

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Naturally-Derived Biomaterials for Tissue Engineering Applications

Brovold

Almeida

Plá-Palacín

et al. 2018

Advances in Experimental Medicine and Biology

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Exploring Portal Vein Hemodynamic Velocities as a Promising, Attractive Horizon for Small-for-Size Syndrome Prediction After Living-Donor Liver Transplantation: An Egyptian Center Study

Cited by 5 publications

References 11 publications

Effect of Portal Venous Pressure on Liver Function of Donors in Living Donor Liver Transplantation

Effect of Portal Venous Pressure on Liver Function of Donors in Living Donor Liver Transplantation

A systematic review of small for size syndrome after major hepatectomy and liver transplantation

Naturally-Derived Biomaterials for Tissue Engineering Applications

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