Splanchnic hyperemia after liver transplantation in patients with end-stage liver disease.
Systemic and splanchnic hemodynamic parameters were evaluated in 12 patients with cirrhosis before and 3 and 6 months after liver transplantation. Results were compared with those obtained in 8 healthy subjects. Three months after liver transplantation recipients had an increase in mean arterial pressure (98 +/- 7 v 78 +/- 9 mmHg; P < .05), an insignificant decrease in cardiac index (3. 4 +/- 0.6 v 4.0 +/- 1.0 L . min-1 . m-2), and a marked increase in peripheral vascular resistance (1,563 +/- 308 v 800 +/- 205 dyne . s . cm-5; P < .05) compared with pretransplantation values. Portal blood flow was also significantly increased (1,494 +/- 200 v 829 +/- 130 mL/min; P < .05). These hemodynamic changes were more pronounced 6 months after transplantation (mean arterial pressure, 100 +/- 8 mmHg; cardiac index, 3.0 +/- 1.0 L . min-1 . m-2; P < .01; peripheral vascular resistance, 1,680 +/- 405 dyne . s . cm-5; portal blood flow, 1,520 +/- 180 mL/min). Systemic hemodynamics 6 months after liver transplantation were similar to those observed in the healthy control group (mean arterial pressure, 95 +/- 6 mmHg; cardiac index, 2.9 +/- 0.9 L . min-1 . m-2; peripheral vascular resistance, 1,480 +/- 380 dyne . s . cm-5). However, portal blood flow was still significantly higher than in healthy controls at 6 months (1,520 +/- 180 v 910 +/- 140 mL/min; P < .05). This study shows that systemic hemodynamics are normalized after liver transplantation. However, an increase in portal blood flow occurs and persists for at least 6 months after liver transplantation. Further studies are needed to clarify the cause of the abnormally high portal flows.
Alvarez
D
D
Sección de Ecografía, Buenos Aires, Argentina.
Gerona
S
S
Waisburg
Z
Z
Ciardullo
M
M
de Santibañes
E
E
Mastai
R
R
D000328:Adult; D001783:Blood Flow Velocity; D001794:Blood Pressure; D005500:Follow-Up Studies; D006801:Humans; D006940:Hyperemia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D017078:Laser-Doppler Flowmetry; D017093:Liver Failure / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D011168:Portal System / Q000000981:diagnostic imaging / Q000503:physiopathology; D011183:Postoperative Complications; D013158:Splenic Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D018617:Ultrasonography, Doppler, Pulsed; D014655:Vascular Resistance