Hemodynamics in the immediate post-transplantation period in alcoholic and viral cirrhosis.
OBJECTIVE
To study the hemodynamics in the immediate post transplant period and compare patients with alcoholic vs viral cirrhosis.


METHODS
Between 2000-2003, 38 patients were transplanted for alcoholic cirrhosis and 28 for postviral cirrhosis. Heart rate (HR), central venous pressure (CVP), mean arterial pressure (MAP), pulmonary capillary wedge pressure (PCWP), cardiac index (CI), systemic vascular resistance index (SVRI), pulmonary artery pressure (PAP), and pulmonary vascular resistance index (PVRI) were measured immediately and 24 h post transplantation.


RESULTS
Hyperdynamic circulation persisted at 24 h following transplantation with an elevated CI of 5.4 +/- 1.3 L/(min x m(2)) and 4.9 +/- 1.0 L/(min x m(2)) in the viral and alcoholic groups, respectively, and was associated with a decreased SVRI. Within the first 24 h, there was a significant decrease in HR and increase in MAP; the extent of the change was similar in both groups. The CVP, PCWP, and SVRI increased, and CI decreased in the viral patients, but not the alcoholic patients. Alcoholics showed a lower PVRI (119 +/- 52 dynes/(cm(5) x m(2)) vs 166 +/- 110 dynes/(cm(5) x m(2)), P < 0.05) and PAP (20 +/- 7 mmHg vs 24 +/- 7 mmHg, P < 0.05) compared to the viral group at 24 h.


CONCLUSIONS
Hyperdynamic circulation persists in the immediate post-transplant period with a faster improvement in the viral group. Alcoholic patients have a more pronounced pulmonary vasodilatation.
Al-Hamoudi
Waleed K
WK
Gastroenterology Unit (59), College of Medicine, King Saud University, PO Box 2925, Riyadh 11461, Saudi Arabia. walhamoudi@gmail.com
Alqahtani
Saleh
S
Tandon
Puneeta
P
Ma
Mang
M
Lee
Samuel S
SS
D000328:Adult; D000368:Aged; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery*; D008104:Liver Cirrhosis, Alcoholic / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012039:Regional Blood Flow; D014777:Virus Diseases / Q000601:surgery*