Is It Possible to Distinguish Between Vasoplegic Syndrome and Postreperfusion Syndrome During Liver Graft Reperfusion?

Cao, Zhongping; Tao, Guocai

doi:10.1213/ane.0b013e3181c9982c

Cited by 2 publications

(4 citation statements)

References 7 publications

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“…Most case reports including ours report administration of MB after reperfusion. Perhaps, as Cao and Tao noted in an editorial response, MB is better suited for the treatment of VS not PRS [ 15 ]. Specifically, VS and the association with increased NO may explain why MB works better when administered following reperfusion [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

The Use of Methylene Blue during Liver Transplantation for Vasoplegia

Harding

Nicholas

Kassel

2021

Case Reports in Anesthesiology

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The use of methylene blue for vasoplegia in cardiac cases with cardiopulmonary bypass, septic shock, and acute liver failure is well documented. Use of MB for liver transplantation has been largely limited to case reports. We describe three separate liver transplantation patients with significant hypotension following reperfusion. Administration of methylene blue to each patient resulted in a significant decrease in vasopressor medication and two patients weaned completely. We argue that the use of MB should be considered as a treatment option for refractory hypotension.

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Section: Discussionmentioning

confidence: 99%

The Use of Methylene Blue during Liver Transplantation for Vasoplegia

Harding

Nicholas

Kassel

2021

Case Reports in Anesthesiology

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“…[1][2][3] The mechanisms of vasoplegic syndrome during liver transplantation remain unclear, but the inflammatory cytokines induced by gastrointestinal tract congestion may play roles in these mechanisms. 3,4 Meanwhile postreperfusion syndrome is defined as a mean arterial pressure decrease of more than 30% over 1 min within 5 min of reperfusion 5,6 ; vasoplegic syndrome differs from postreperfusion syndrome in terms of etiology, symptoms, and treatment. 4 In recent years, segments of intact arteries removed from patients undergoing surgery were used to study the vascular responses induced by different factors.…”

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confidence: 99%

“…3,4 Meanwhile postreperfusion syndrome is defined as a mean arterial pressure decrease of more than 30% over 1 min within 5 min of reperfusion 5,6 ; vasoplegic syndrome differs from postreperfusion syndrome in terms of etiology, symptoms, and treatment. 4 In recent years, segments of intact arteries removed from patients undergoing surgery were used to study the vascular responses induced by different factors. In one study, ring segments of isolated pulmonary arteries and radial arteries obtained from patients undergoing lung resection or coronary artery bypass graft surgery were used to examine the contractile responses to different vasoactive drugs.…”

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confidence: 99%

“…For example, the inflammatory cytokines induced by gastrointestinal tract congestion during liver transplantation may have an impact on the vascular endothelial cells and may affect vascular tension. 3,4 P38 mitogen-activated protein kinase (P38 MAPK) is a very important branch of MAPK pathway, as part of an important intracellular signal transduction system plays a key role in a variety of cellular responses involved in inflammation, cell stress, apoptosis, cell cycle and growth in physiological, and pathological processes. 9,10 In this study, we used an isolated hepatic artery ring segment model (obtained from dissected livers derived from orthotopic liver transplantation) to explore whether the inflammatory cytokines induced by gastrointestinal tract congestion exert an effect on vascular endothelial cells and isolated hepatic artery ring tension.…”

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confidence: 99%

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Gastrointestinal Congestion Dilates the Hepatic Artery Through the P38 MAPK Signal Transduction Pathway During Liver Transplantation

Cao

Tang

Hou³

2016

ASAIO Journal

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During the neohepatic stage of liver transplantation, hemodynamics change markedly. The current study aimed to investigate whether gastrointestinal congestion caused by inferior vena cava and hepatic portal vein clamping can dilate the hepatic artery and to determine the associated mechanisms. Ring segments of the hepatic artery were treated with the plasma from gastrointestinal congestion or the superior vena cava. The fractions in gastrointestinal congestion and the superior vena cava plasma were tested, and the effect of these fractions on the tone of the hepatic artery ring was examined. Different signal transduction blockers and different inhibitors were then used to determine the exact signal transduction pathway involved. In addition, endothelial cell structure was observed by transmission electron microscopy after treatment with the gastrointestinal congestion plasma or the superior vena cava plasma. Gastrointestinal congestion plasma contained more inflammatory cytokines than superior vena cava plasma, and these cytokines could cause hepatic artery ring dilatation. A P38 mitogen-activated protein kinase (P38 MAPK) signal transduction pathway blocker and nitric oxide (NO), prostaglandin (PGI2), nuclear factor-κB (NF-κB), and adenosine triphosphate (ATP)-sensitive K (KATP) channel inhibitors were able to significantly reverse the ring tension caused by gastrointestinal congestion plasma. The normal endothelium was also injured by treatment with gastrointestinal congestion plasma. The inflammatory cytokines in gastrointestinal congestion can cause hepatic artery ring dilatation through the P38 MAPK signal transduction pathway, and this phenomenon is also associated with NO, PGI2, NF-κB, and the KATP channel. These inflammatory cytokines can injure endothelial cells in the hepatic artery.

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Is It Possible to Distinguish Between Vasoplegic Syndrome and Postreperfusion Syndrome During Liver Graft Reperfusion?

Cited by 2 publications

References 7 publications

The Use of Methylene Blue during Liver Transplantation for Vasoplegia

The Use of Methylene Blue during Liver Transplantation for Vasoplegia

Gastrointestinal Congestion Dilates the Hepatic Artery Through the P38 MAPK Signal Transduction Pathway During Liver Transplantation

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