Direct measurement of hepatic blood flow during living donor liver transplantation in children.
BACKGROUND
The changes in liver blood flow associated with living donor liver transplantation (LDLT) in children have not yet been studied. The aim of the present study was to investigate changes in hepatic hemodynamics before and after pediatric partial liver transplantation.


METHODS
In 7 pediatric recipients with congenital cholestasis and native liver Child-Pugh classes B and C, portal vein flow (PVF) and hepatic arterial flow (HAF) were measured using an ultrasonic transit time flow meter before removal of the native liver and after transplantation and compared with donor left PVF and donor left HAF.


RESULTS
The mean portal contribution to total hepatic blood flow was markedly decreased in the recipient native liver compared with that in the donor (69% +/- 15% vs 32% +/- 15%; P = .0003) and after reperfusion changed to almost the same ratio as that in the donor liver (73% +/- 18%; P < .0001).


CONCLUSIONS
The extreme imbalance between PVF and HAF that is common in implanted partial liver in adult LDLT recipients was not observed in pediatric LDLT. After transplantation of an appropriately sized liver graft, the portal contribution to total liver blood flow normalized to the value for normal liver.
Omori
Satoshi
S
Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
Ishizaki
Yoichi
Y
Sugo
Hiroyuki
H
Yoshimoto
Jiro
J
Imamura
Hiroshi
H
Yamataka
Atsuyuki
A
Kawasaki
Seiji
S
D000367:Age Factors; D001783:Blood Flow Velocity; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006439:Hemodynamics / Q000502:physiology*; D006499:Hepatic Artery / Q000502:physiology*; D006801:Humans; D007223:Infant; D008099:Liver / Q000098:blood supply / Q000601:surgery; D008102:Liver Circulation / Q000502:physiology*; D016031:Liver Transplantation / Q000009:adverse effects / Q000000981:diagnostic imaging / Q000379:methods*; D019520:Living Donors; D008297:Male; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000503:physiopathology; D011300:Preoperative Care / Q000379:methods; D011336:Probability; D012189:Retrospective Studies; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex