Whole body oxygen uptake is not a good indicator of liver allograft function following orthotopic liver transplantation.
Variations of whole body oxygen uptake (VO2) have been studied during orthotopic liver transplantation. Some authors have suggested that the increase in VO2 after revascularization of the graft could be an index of good function of the grafted liver and thus low VO2 an early sign of primary non-function. The purpose of our study was to assess the temporal course of measured respiratory VO2 and to compare the VO2 changes to indicators of hepatic function. We used a metabolic monitor (Deltatrac, Datex Corp. Finland) to measure VO2 in 18 patients during transplantation. Clotting factors II and V at 1, 3, 7, 14 and 21 days post-operatively and peak serum transaminases within the first 3 post-operative days were determined. Variations of VO2 were a decrease during the anhepatic phase and an increase following the reperfusion phase as compared to the VO2 value obtained at the beginning of the procedure. No correlation was found between the increase in VO2 after reperfusion of the graft and either factor II (r = 0.33-0.4), factor V (r = 0.23-0.43) or peak transaminases (r = 0.13). One patient developed a primary non-function of the graft. For this patient VO2 increased far above the pre-anhepatic values. The authors conclude that VO2 is not a reliable sign of graft function.
Albaladejo
P
P
Department d'Anesthésie-Réanimation, Hôpital Paul Brousse, Université Paris-Sud, Villejuif, France.
Jugan
E
E
Descorps-Declere
A
A
Jayais
P
P
Ecoffey
C
C
D000293:Adolescent; D000328:Adult; D000771:Anesthesia, Intravenous; D001219:Aspartate Aminotransferases / Q000097:blood; D003250:Constriction; D005165:Factor V / Q000032:analysis; D006498:Hepatectomy; D006801:Humans; D016031:Liver Transplantation / Q000379:methods / Q000502:physiology*; D008875:Middle Aged; D009929:Organ Size; D010101:Oxygen Consumption / Q000502:physiology*; D011167:Portacaval Shunt, Surgical; D011169:Portal Vein / Q000601:surgery; D011516:Prothrombin / Q000032:analysis; D013997:Time Factors; D014184:Transplantation, Homologous; D014682:Vena Cava, Inferior / Q000601:surgery
D005165:Factor V; D011516:Prothrombin; D001219:Aspartate Aminotransferases