Splanchnic non-hepatic hemodynamics and metabolism during liver transplantation.
OBJECTIVE
The aim of this study is to compare the splanchnic non-hepatic hemodynamics and the metabolic changes during orthotopic liver transplantation between the conventional with bypass and the piggyback methods.


METHODS
A prospective, consecutive series of 59 primary transplants were analyzed. Oxygen consumption, glucose, potassium, and lactate metabolism were quantitatively estimated from blood samples from the radial artery and portal vein, collected up to 120 minutes after graft reperfusion. Mean arterial pressure, portal venous pressure, portal venous blood flow, and splanchnic vascular resistance were also measured or calculated at postreperfusion collection times.


RESULTS
There was a greater increase in portal venous blood flow (p=0.05) and lower splanchnic vascular resistance (p=0.04) in the piggyback group. Mean arterial pressure and portal venous pressure were similar for both groups. Oxygen, glucose and potassium consumption were higher in the piggyback group, but none of the metabolic parameters differed significantly between groups.


CONCLUSIONS
In conclusion, the study detected a higher portal venous blood flow and a lower and splanchnic vascular resistance associated with the piggyback technique. After graft reperfusion, no difference in the splanchnic non-hepatic metabolic parameters was observed between the conventional with bypass and the piggyback methods of orthotopic liver transplantation.
5Liver Unit, Instituto Dante Pazzanese de Cardiologia, University of São Paulo Medical School, São Paulo, Brazil.
Ana Olga Nagano Fernandes
AO
Mies
Paulo Celso Bosco
PC
Massarollo
Thomson Marques
TM
Palma
Sergio
S
Mies
D000328:Adult; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D016031:Liver Transplantation / Q000379:methods* / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011169:Portal Vein / Q000502:physiology; D011446:Prospective Studies; D012039:Regional Blood Flow; D013152:Splanchnic Circulation / Q000502:physiology*; D014655:Vascular Resistance / Q000502:physiology
D005947:Glucose