Functional changes of the heart and lung in perioperative period of orthotopic liver transplantation.
OBJECTIVE
To investigate the variation of functions of the heart and lung during orthotopic liver transplantation (OLT).


METHODS
Pulmonary artery cannula and right radial artery cannula were indewelled before anaesthesia and the parameters of hemodynamics in different periods were monitored. Analysis of variance was used to reveal the variation among the groups. T hypothesis test in paired data was used to compare the preoperative parameters with those in each period during operation and after operation respectively, and to compare the parameters immediately after operation with those in each period after operation respectively.


RESULTS
During the operation, heart rate increased, but blood pressure decreased significantly at the beginning of no-liver period, increased again in a short period and then increased progressively 12 h after operation. Pulmonary artery pressure (PAP) increased from before the no-liver period to 60 h after operation. Pulmonary wedge pressure changed in accordance with the variation of PAP. Cardiac output was maintained at a high-output level from before operation to 60 h after operation. Systemic vascular resistance (SVR) was within the normal limits before operation, whereas pulmonary vascular resistance (PVR) was lower than normal. In the no-liver period during the operation, SVR decreased significantly. Both SVR and PVR increased progressively and returned to normal postoperatively.


CONCLUSIONS
The patients undergoing OLT have a high cardiac output and low resistance obstacle before and during the operation, and will recover gradually after operation. Monitoring hemodynamics during the peri-operative period is of significance in the prevention and treatment of pneumonedema and cardiac functional insufficiency.
Zheng
Shu-Sen
SS
Department of Hepatobiliary Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China. zhengss@mail.hz.zj.cn
Lu
An-Wei
AW
Huang
Dong-Sheng
DS
Chen
Qing-Lian
QL
Xu
Lin-Zhen
LZ
D000328:Adult; D001794:Blood Pressure; D002302:Cardiac Output; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D016031:Liver Transplantation; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011651:Pulmonary Artery / Q000503:physiopathology; D011669:Pulmonary Wedge Pressure; D014655:Vascular Resistance