Simulation of portal hemodynamic changes in a donor after right hepatectomy.
Remnant livers will be regenerated in live donors after a large volume resection for transplantation. How the structures and hemodynamics of portal vein will evolve with liver regeneration remains unknown. This prompts the present hemodynamic simulation for a 25 year-old man who received a right donor lobectomy. According to the magnetic resonance imaging/computed tomography images taken prior to the operation and one month after the operation, three sequential models of portal veins (pre-op, immediately after the operation, and one-month post-op) were constructed by AMIRA and HYPERMESH, while the immediately after the operation model was generated by removing the right branch in the pre-op model. Hemodynamic equations were solved subject to the sonographically measured inlet velocity. The simulated branch velocities were compared with the measured ones. The predicted overall pressure in the portal vein after resection was found to increase to a magnitude that has not reached to an extent possibly leading to portal hypertension. As expected, blood pressure has a large change only in the vicinity of the resection region. The branches grew considerably different from the original one as the liver is regenerated. Results provide useful evidence to justify the current computer simulation.
Ho
Cheng-Maw
CM
Department of Surgery, National Taiwan University Hospital, Taipei, 100 Taiwan, R.O.C.
Lin
Reui-Kuo
RK
Tsai
Shun-Feng
SF
Hu
Rey-Hen
RH
Liang
Po-Chin
PC
Sheu
Tony Wen-Hann
TW
Lee
Po-Huang
PH
D000818:Animals; D001783:Blood Flow Velocity; D003198:Computer Simulation; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000503:physiopathology* / Q000601:surgery*; D008102:Liver Circulation; D008955:Models, Cardiovascular; D011169:Portal Vein / Q000503:physiopathology*