Postoperative haemodynamic changes in transplanted liver: Long-term follow-up with ultrasonography

Han, Hong; Liu, Rong; Wang, Wenping; Ding, Hong; Wen, Jian; Lin, Xinhua

doi:10.1177/0300060514521153

Cited by 12 publications

(19 citation statements)

References 27 publications

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“…7 1] cm/s at 1 month after transplant (P < .05). 3 In addition, in a series on 51 DDLT recipients, Stell and associates found that the mean portal venous flow decreased by approximately 20% in the first postoperative week. 1 Previous studies have reported marked hemodynamic changes after reperfusion of a partial graft in LDLT versus those occurring in DDLT.…”

Section: Omar Abdelaziz Et Al/experimental and Clinical Transplantatimentioning

confidence: 96%

“…Low HA RI can also be observed in other pathologic conditions, including HA stenosis, severe aorto-celiac athe rosclerotic disease, arteriovenous or arterial biliary fistula formation, and hepatic vein or portal vein thrombosis. 3 We observed an intraoperative elevation of HA PSV (range, 20-300 cm/s; mean [SD] of 96. 3 [65] cm/s) with significant decline in the first day after transplant without long-term consequences.…”

Section: Omar Abdelaziz Et Al/experimental and Clinical Transplantatimentioning

confidence: 96%

“…3 We observed an intraoperative elevation of HA PSV (range, 20-300 cm/s; mean [SD] of 96. 3 [65] cm/s) with significant decline in the first day after transplant without long-term consequences. There was also intraoperative elevation of anastomotic-topreanastomotic velocity ratio (range, 1-5; mean [SD] of 1.32 [0.56]).…”

Section: Omar Abdelaziz Et Al/experimental and Clinical Transplantatimentioning

confidence: 96%

“…5 The splanchnic circulation shows rapid and potentially reversible changes in the portal and arterial perfusion and may not be clinically significant. 3,6,7 In LDLT, the hemodynamic changes are much more pronounced than in DDLT, with a high perfusion state that is predominantly portal with increases in the PV flow and velocities and increased HA resistance. [8][9][10] Analysis of Doppler ultrasonographic findings may be confusing intrao peratively and in the early period after transplant due to complex vascular anastomoses, donor-recipient vascular size mismatch, and reduced graft volume.…”

Section: Omar Abdelaziz Et Al/experimental and Clinical Transplantatimentioning

confidence: 99%

“…1,2 However, the immediate changes in the splanchnic hemodynamics after graft perfusion and the physiologic changes during graft recovery are still under debate. 3 Few reports have investigated early graft hemodynamics by using Doppler ultrasonography after LDLT, with hemodynamics with LDLT influenced by the complex vascular anastomosis and small graft volume compared with deceased-donor liver transplant (DDLT).…”

Section: Introductionmentioning

confidence: 99%

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Abdelaziz

Emad‐Eldin²,

Hussein³

et al. 2017

Exp Clin Transplant

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Objectives: Our aim was to investigate the early changes that occur after graft perfusion in livingdonor liver transplant by Doppler ultrasonography. Materials and Methods: We prospectively evaluated liver grafts of 30 patients who underwent living-donor liver transplant during an 18-month period and who were followed for 1 year postoperatively. The hepatic artery peak systolic velocity, resistivity index, portal vein velocity, portal vein anastomotic velocity ratio, and hepatic vein pattern were compared after excluding patients who developed vascular complications and acute rejection episodes. Results: We observed intraoperative increases in the mean hepatic artery peak systolic velocity (96.3 ± 65 cm/s), the resistivity index (0.78 ± 0.091), and the portal vein velocity (99.6 ± 48 cm/s), which started to normalize after 2 weeks. In comparing the mean portal vein velocity, portal vein anastomotic velocity ratio, hepatic artery peak systolic velocity, and resistivity index after excluding 5 patients who developed vascular complications, we observed overall significance levels of P < .001, P = .039, P < .001, and P = .040. After we excluded 9 patients who developed acute rejection, our comparison of the portal vein velocity, hepatic artery peak systolic velocity, and resistivity index showed overall significance (P < .001, P < .001, and P = .043). Conclusions: Early and transient increases in portal vein velocity, anastomotic velocity ratio, hepatic artery peak systolic velocity, and resistivity index are common after living-donor liver transplant, with significant declines in the first 2 weeks posttransplant.

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Section: Omar Abdelaziz Et Al/experimental and Clinical Transplantatimentioning

confidence: 96%

Section: Omar Abdelaziz Et Al/experimental and Clinical Transplantatimentioning

confidence: 96%

Section: Omar Abdelaziz Et Al/experimental and Clinical Transplantatimentioning

confidence: 96%

Section: Omar Abdelaziz Et Al/experimental and Clinical Transplantatimentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Abdelaziz

Emad‐Eldin²,

Hussein³

et al. 2017

Exp Clin Transplant

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Anästhesie bei organtransplantierten Patient:innen

Fiala,

Breitkopf,

Sinner

et al. 2023

Anaesthesiologie

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ZusammenfassungOrgantransplantierte Patient:innen, die sich einem operativen Eingriff unterziehen müssen, der nicht im Zusammenhang mit ihrer Transplantation steht, können die betreuenden Anästhesist:innen vor große Herausforderungen stellen. Einerseits gilt es, die Transplantatfunktion in der perioperativen Phase sorgfältig hinsichtlich des Auftretens einer etwaigen Abstoßungsreaktion zu überwachen. Andererseits müssen die laufende Immunsuppression ggf. bezüglich des Wirkstoffes und/oder des Applikationsweges den perioperativen Erfordernissen angepasst sowie das sich aus ihr ergebende erhöhte Infektionsrisiko und mögliche Nebenwirkungen (wie z. B. Myelosuppression, Nephrotoxizität, Beeinträchtigung der Wundheilung usw.) in das perioperative Behandlungskonzept integriert werden. Des Weiteren sind möglicherweise persistierende Komorbiditäten der Grunderkrankung sowie physiologische Spezifika infolge der Organtransplantation zu beachten. Hierbei kann auf die Expertise das jeweiligen Transplantationszentrums zurückgegriffen werden.

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Doppler-ultrasound reference values after pediatric liver transplantation: a consecutive cohort study

et al. 2023

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Objectives Doppler ultrasound (DUS) is the main imaging modality to evaluate vascular complications of pediatric liver transplants (LT). The current study aimed to determine reference values and their change over time. Methods A consecutive cohort of pediatric patients undergoing an LT were retrospectively included between 2015 and 2020. Timepoints for standardized DUS were intra-operative and postoperative (day 0), days 1–7, months 1 and 3, and years 1 and 2. DUS measurements of the hepatic artery (HA), portal vein (PV), and hepatic vein(s) (HV) were included if there were no complications during 2 years follow-up. Measurements consisted of: peak systolic velocity (PSV) and resistive index (RI) for the HA, PSV for the PV, and venous pulsatility index (VPI) for the HV. Generalized estimating equations were used to analyze change over time. Results One hundred twelve pediatric patients with 123 LTs were included (median age 3.3 years, interquartile range 0.7–10.1). Ninety-five HAs, 100 PVs, and 115 HVs without complications were included. Reference values for HA PSV and RI, PV PSV, and HV VPI were obtained for all timepoints (4043 included data points in total) and presented using 5th–95th percentiles and threshold values. All reference values changed significantly over time (p = 0.032 to p < 0.001). Conclusions DUS reference values of hepatic vessels in children after LT are presented, reference values change over time with specific vessel-dependent patterns. Timepoint–specific reference values improve the interpretation of DUS values and may help to better weigh their clinical significance. Key Points • Doppler ultrasound reference values of pediatric liver transplantations are not static but change over time. Applying the correct reference values for the specific timepoint may further improve the interpretation of the measurements. • The pattern of change over time of Doppler ultrasound measurements differs between the hepatic vessel and measurement; knowledge of these patterns may help radiologists to better understand normal postoperative hemodynamic changes.

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Postoperative haemodynamic changes in transplanted liver: Long-term follow-up with ultrasonography

Cited by 12 publications

References 27 publications

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Untitled

Anästhesie bei organtransplantierten Patient:innen

Doppler-ultrasound reference values after pediatric liver transplantation: a consecutive cohort study

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