title: Changes in liver function parameters after occlusion of gastrorenal shunts with balloon-occluded retrograde transvenous obliteration.
abstract: OBJECTIVE
  To evaluate the effects of portal blood flow on liver function, this pilot study investigated the correlation between changes in portal blood flow as measured by image-directed Doppler ultrasonography and liver function tests in nine patients with cirrhosis who were treated with balloon-occluded retrograde transvenous obliteration. All patients had large gastric varices and prominent gastrorenal shunts.
  
  
  RESULTS
  Treatment caused a significant increase (p < 0.01) in portal blood flow; we documented reversion from hepatofugal to hepatopetal portal flow in one patient and increases in hepatopetal flow from 5.4 +/- 1.1 to 7.85 +/- 1.4 cm/s (mean +/- SD) in eight patients. All patients showed decreases in gastric variceal size. However, portal pressure rose significantly in all patients after treatment from 25.4 +/- 7.6 to 30.7 +/- 5.8 mmH2O (n = 7, mean +/- SD), and two of nine patients had worsening of esophageal varices. All nine patients showed improvement in the 15-min retention rate of indocyanine green from 31.8 +/- 16.1 to 21.8 +/- 12.4% (mean +/- SD, p < 0.01), whereas seven patients showed increased serum albumin levels after treatment.
  
  
  CONCLUSIONS
  These results suggest balloon-occluded retrograde transvenous obliteration increases hepatic portal blood flow, which may be accompanied by improvements in liver function.
authors.affiliation: Third Department of Internal Medicine, Tohoku University School of Medicine, Aoba-ku, Sendai, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Akahane
authors.forename: T
authors.initials: T
authors.lastname: Iwasaki
authors.forename: N
authors.initials: N
authors.lastname: Kobayashi
authors.forename: N
authors.initials: N
authors.lastname: Tanabe
authors.forename: N
authors.initials: N
authors.lastname: Takahashi
authors.forename: H
authors.initials: H
authors.lastname: Gama
authors.forename: M
authors.initials: M
authors.lastname: Ishii
authors.forename: T
authors.initials: T
authors.lastname: Toyota
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D003097:Collateral Circulation; D004396:Coloring Agents; D003287:Contrast Media; D004932:Esophageal and Gastric Varices / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D007479:Iopamidol; D007668:Kidney / Q000098:blood supply; D008099:Liver / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009829:Oleic Acids / Q000627:therapeutic use; D010865:Pilot Projects; D017082:Portal Pressure; D011168:Portal System / Q000000981:diagnostic imaging / Q000503:physiopathology; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods*; D012709:Serum Albumin / Q000032:analysis; D013270:Stomach / Q000098:blood supply; D018608:Ultrasonography, Doppler
chemical_list: D004396:Coloring Agents; D003287:Contrast Media; D009829:Oleic Acids; D012597:Sclerosing Solutions; D012709:Serum Albumin; D007208:Indocyanine Green; D007479:Iopamidol; C033343:ethanolamine oleate