[Hemodynamic changes in orthotopic transplantation of the liver].
OBJECTIVE
To evaluate the hemodynamic changes during orthotopic liver transplantation (OLT).


METHODS
Retrospective analysis of the hemodynamic data during OLT.


METHODS
National Cancer Hospital.


METHODS
Thirty-two patients with hepatic neoplasia and various degrees of cyrrhosis classified according to Child-Pugh.


METHODS
Orthotopic liver transplantation.


RESULTS
For each of the six phases of the operation a complete hemodynamic profile was reported as general mean and as mean of each Child class. The catecholamins given were also reported. At baseline the Child C showed a cardiac index (CI) and heart rate higher than others. At the end of first phase the blood pressure (BP) of the Child C lowered more than the others'. The anhepatic phase was stable. At reperfusion CI increased, the systemic resistances and BP decreased in all the classes. The Child C needed more catecholamins at this time. In the last profile all tended to return to baseline values.


CONCLUSIONS
The baseline hemodynamic was the more hyperdynamic the more sever was the cyrrhosis. The Child C, despite a meticolous fluid therapy, were prone to hypotension in response to even minimal decreases of filling pressures. At reperfusion an hemodynamic disturbance featured by systemic vasodilation occurred. It was more severe in the hyperdynamic patients and it was time limited. The causes of this disturbances have not yet been fully elucidated.
Ammatuna
M
M
Divisione di Anestesia, Istituto Nazionale Studio e Cura dei Tumori, Milano.
di Bartolomeo
S
S
Maucione
A
A
Rigillo
G
G
D000328:Adult; D006439:Hemodynamics; D006801:Humans; D016031:Liver Transplantation / Q000502:physiology*; D008875:Middle Aged; D012189:Retrospective Studies
Modificazioni emodinamiche durante trapianto ortotopico di fegato.