title: Assessment of ventricular contractile function during orthotopic liver transplantation.
abstract: Hemodynamic alterations are a well-known phenomenon that influence the outcome of orthotopic liver transplantation (OLT). Whether or not myocardial dysfunction, which has various causes, contributes to this instability is still debated. Previous transesophageal echocardiography (TEE) studies have presented controversial data, not leading to final clarification. This is mainly because the impact of other contributing factors (inotropic support, alternating preload conditions and temperature) remained unaccounted for. We therefore measured the left ventricular shortening fraction (LVSF), a parameter reflecting myocardial contractility, in 10 consecutive patients undergoing OLT without veno-venous bypass. We measured during preparation (PP), during the anhepatic (AP) phase and the immediate reperfusion phase (RP). During the AP we observed a significant decrease of LVSF which never fell to subnormal levels in the majority of our patients, whereas during the RP, LVSF returned to PP values. These findings support the assumption that myocardial function is influenced by OLT, but that it plays only a minor role in the occurrence of hemodynamic instability, which could mainly be attributed to volume fluctuations.
authors.affiliation: Department of Anesthesiology, University Hospital of Vienna, 1090 Vienna, Austria. claus.krenn@univie.ac.at
authors.forename: Claus G
authors.initials: CG
authors.lastname: Krenn
authors.forename: Rashid
authors.initials: R
authors.lastname: Hoda
authors.forename: Ajsa
authors.initials: A
authors.lastname: Nikolic
authors.forename: Manfred
authors.initials: M
authors.lastname: Greher
authors.forename: Walter
authors.initials: W
authors.lastname: Plöchl
authors.forename: Orest O
authors.initials: OO
authors.lastname: Chevtchik
authors.forename: Heinz
authors.initials: H
authors.lastname: Steltzer
mesh_terms: D001794:Blood Pressure; D002302:Cardiac Output; D004452:Echocardiography; D006339:Heart Rate; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D016031:Liver Transplantation / Q000502:physiology*; D009200:Myocardial Contraction / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*