Hepatic Vein Flow Index During Orthotopic Liver Transplantation as a Predictive Factor for Postoperative Early Allograft Dysfunction

Morita, Yoshiro; Kariya, Taro; Nagai, Shunji; Itani, Ahmad; Isley, Michael; Tanaka, Kenichi A.

doi:10.1053/j.jvca.2020.12.034

Cited by 2 publications

(1 citation statement)

References 32 publications

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“…Studies have found that left hepatic lobe to right hepatic fossa and right hepatic lobe to left hepatic fossa are related to the atrophy of grafts; grafts not in the original hepatic fossa are prone to tension, distortion, stretching, and atrophy ( 16 , 20 ). In addition, studies have shown that hepatic vein blockage is also related to liver graft atrophy ( 22 , 30 – 32 ). If one side of the hepatic vein is blocked, blood flow does not proceed smoothly or the flow rate is slow compared with the other side of the graft hepatic vein ( 30 ).…”

Section: Introductionmentioning

confidence: 99%

Preliminary study of donor volume changes after dual-graft liver transplantation in rats

Wang,

Ma,

et al. 2023

Front. Immunol.

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Dual-graft liver transplantation (DGLT) expands the pool of donors, ensures the safety of the donors, and treats a potential small for size syndrome (SFSS). However, some of the recipient graft showed atrophy. The cause and mechanism of the unbalanced proliferation and atrophy of dual grafts after clinical DGLT have not been clarified. We established and optimized the rat model of DGLT to explore the causes of growth unbalance. Continuously and dynamically observed bilateral graft volume and portal vein blood flow change by magnetic resonance imaging (MRI) and ultrasound (US). We detected liver function indexes: alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL). Liver samples from receptors were obtained for morphology, and apoptosis was measured by RT-PCR and western blot. Optimization of the model improved the 7-day survival rate from former 58.3% to 87.5%, and the 30-day survival rate was 68.8%. The volume of the right graft gradually increased, and the left graft atrophied during the 30-day observation period. The portal blood flow of the left graft gradually decreased until the 30th day (0.13 ± 0.01 ml/s) compared with the sham group (0.63 ± 0.05 ml/s), and the right graft significantly increased on the 30th day (0.75 ± 0.11ml/s). The liver function initially increased and then recovered. The total volume (12.52 ± 1.60 ml vs 4.47 ± 0.08 ml) and weight (12.09 ± 1 g vs 4.91 ± 0.18 g) of the graft increased significantly compared to pre-transplantation and reached the level of the sham operation group on the 30th day. The volume and weight of the right graft increased more than those of the left graft (P < 0.05). There was more inflammatory cell infiltration in the left graft, and the right graft had obvious proliferation of hepatocytes and mature bile duct cells. Left grafts were more prone to apoptosis than right grafts (P < 0.05). In conclusion, growth of the right graft is superior to the left; after double liver transplantation, perfusion blood flow and apoptosis may be the reason contributing to the volume differences in dual grafts.

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Section: Introductionmentioning

confidence: 99%

Preliminary study of donor volume changes after dual-graft liver transplantation in rats

Wang,

Ma,

et al. 2023

Front. Immunol.

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Utility of Transesophageal Echocardiography During Orthotopic Liver Transplantation: A Narrative Review

Hansebout,

Desai,

Dhir

2023

Annals of Cardiac Anaesthesia

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Orthotopic liver transplantation (OLT) is the standard of care for patients suffering from end stage liver disease (ESLD). This is a high-risk procedure with the potential for hemorrhage, large shifts in preload and afterload, and release of vasoactive mediators that can have profound effects on hemodynamic equilibrium. In addition, patients with ESLD can have preexisting coronary artery disease, cirrhotic cardiomyopathy, porto-pulomary hypertension and imbalanced coagulation. As cardiovascular involvement is invariable and patient are at an appreciable risk of intraoperative cardiac arrest, Trans esophageal echocardiography (TEE) is increasingly becoming a routinely utilized monitor during OLT in patients without contraindications to its use. A comprehensive TEE assessment performed by trained operators provides a wealth of information on baseline cardiac function, while a focused study specific for the ESLD patients can help in prompt diagnosis and treatment of critical events. Future studies utilizing TEE will eventually optimize examination safety, quality, permit patient risk stratification, provide intraoperative guidance, and allow for evaluation of graft vasculature.

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Hepatic Vein Flow Index During Orthotopic Liver Transplantation as a Predictive Factor for Postoperative Early Allograft Dysfunction

Cited by 2 publications

References 32 publications

Preliminary study of donor volume changes after dual-graft liver transplantation in rats

Preliminary study of donor volume changes after dual-graft liver transplantation in rats

Utility of Transesophageal Echocardiography During Orthotopic Liver Transplantation: A Narrative Review

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