[A clinical study on splanchnic hemodynamic changes after orthotopic liver transplantation for patients with portal hypertension].
OBJECTIVE
To study the regularity of splanchnic hemodynamic changes after orthotopic liver transplantation (OLT) for patients with portal hypertension. At the same time, effect of such changes on splenomegaly, hypersplenism, collateral circulation and the postoperative liver function was discussed.


METHODS
Between June 2002 and October 2005, 173 liver transplantations were performed. In 38 patients with portal hypertension undergoing OLT, the following parameters were measured before surgery and subsequently at 1, 3, 5, 7 days, 1, 6 months and 1, 2, 3 years after operation by using Color Doppler sonography: portal blood flow mean velocity (PBV), portal blood flow volume (PBF), hepatic artery resistance indexes (HA-RI) and spleen size. The same parameters were measured in 8 patients with acute liver failure and 20 healthy controls. Meanwhile to observe liver function and varicose vein of esophagus.


RESULTS
In cirrhotics, PBV and PBF increased immediately after transplantation [from (13.7 +/- 4.2) cm/s to (58.4 +/- 25.2) cm/s and from (958 +/- 445) ml/min to (3024 +/- 1207) ml/min respectively, P < 0.05]. HA-RI also augmented [from (0.65 +/- 0.11) to (0.74 +/- 0.12), P < 0.05]. PBV returned to normal values after 6 months, PBF returned to normal value after 2 years. Spleen size decreased significantly, but splenomegaly persisted after 3 years. In addition the esophagogastric varix ameliorated significantly.


CONCLUSIONS
Abnormal splanchnic hemodynamic changes for patients with portal hypertension still will long-term exist after OLT, but does not effect recovery of hypersplenism, esophagogastric varix and liver function.
Jiang
Shui-ming
SM
Department of Surgery, Shanghai Institute of Digestive Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
Zhou
Guang-wen
GW
Shen
Chuan
C
Yan
Jie-qi
JQ
Wan
Liang
L
Li
Qin-yu
QY
Yang
Wei-ping
WP
Shen
Bai-yong
BY
Chen
Hao
H
Peng
Cheng-hong
CH
Li
Hong-wei
HW
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006499:Hepatic Artery / Q000503:physiopathology; D006801:Humans; D006975:Hypertension, Portal / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D007432:Intraoperative Period; D008099:Liver / Q000503:physiopathology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000503:physiopathology; D013152:Splanchnic Circulation / Q000502:physiology*; D013154:Spleen / Q000473:pathology