title: Intraoperative flow measurement of native liver and allograft during orthotopic liver transplantation in children.
abstract: Hepatic hemodynamic changes during liver transplantation (OLT) in children have not yet been studied. We measured intraoperative portal vein flow (PVF) and hepatic arterial flow (HAF) (mL/min) in 53 children and 58 grafts during OLT. Flows were measured in the native organ and in the allograft. In the native liver, PVF and HAF are similar; after transplantation they return to the physiological situation. No flow differences were seen between whole and partial grafts. Among the 8 (14%) portal vein thromboses, PVF was lower in both the native liver and the graft than in the no thrombosis group (P < .05). PVF <5 mL/min/kg was a risk factor to develop PV thrombosis. No graft loss occurred in 3 cases without PVF at the time of OLTs despite the observation that repermeabilization was not possible. In 4 patients with PVF <5 mL/min/kg, after tying a spontaneous spleno-renal shunt (n = 3) or performing a porto-renal vein anastomosis (n = 1), PVF reached >20 mL/min/kg, avoiding thrombosis. In conclusion, PVF and HAF measurements during pediatric OLT may predict patients at high risk for development of PV thrombosis.
authors: Liver Transplant Unit and Pediatric Surgery Department, Hospital Valle de Hebron, Barcelona, Spain. jbueno@vhebron.net
authors: J
authors: J
authors: Bueno
authors: A
authors: A
authors: Escartín
authors: J
authors: J
authors: Balsells
authors: C
authors: C
authors: Margarit
mesh_terms: D001783:Blood Flow Velocity; D002648:Child; D006499:Hepatic Artery / Q000502:physiology; D006801:Humans; D008102:Liver Circulation; D016031:Liver Transplantation; D016343:Monitoring, Intraoperative; D011169:Portal Vein / Q000502:physiology; D013927:Thrombosis / Q000175:diagnosis; D014184:Transplantation, Homologous