title: Hepatic arterial buffer response after pediatric living donor liver transplantation: report of a case.
abstract: BACKGROUND
  Excessive portal pressure at an early stage after living-donor liver transplantation (LDLT) can damage sinusoidal endothelial cells and hepatocytes through shear stress leading to graft failure, or hepatic arterial complications due to low hepatic artery flow from a hepatic arterial buffer response. We encountered a case in which excessive portal vein flow was observed from an early stage after pediatric LDLT. The hepatic artery flow decreased due to a hepatic arterial buffer response.
  
  
  METHODS
  A 6-month-old boy with biliary atresia showed excessive portal vein flow early after LDLT with a decreasing hepatic artery flow without anastomotic stenosis from postoperative day 3. The PV flow gradually exhibited a decrease at approximately postoperative day 8 and, similtaneously, hepatic artery flow exhibited improvement.
  
  
  CONCLUSIONS
  Because excessive portal pressure after LDLT is reversible, it has been suggested that it may be possible to prevent the progress of hepatic arterial complications if temporary portal pressure modulation can be performed for cases among the high-risk group for hepatic arterial complications.
authors.affiliation: Department of Transplant Surgery, Jichi Medical University, and Department of Pharmacy, Jichi Medical University Hospital, Shimotsuke City, Tochigi, Japan. yuki371@jichi.ac.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Sanada
authors.forename: K
authors.initials: K
authors.lastname: Mizuta
authors.forename: T
authors.initials: T
authors.lastname: Urahashi
authors.forename: Y
authors.initials: Y
authors.lastname: Ihara
authors.forename: T
authors.initials: T
authors.lastname: Wakiya
authors.forename: N
authors.initials: N
authors.lastname: Okada
authors.forename: N
authors.initials: N
authors.lastname: Yamada
authors.forename: S
authors.initials: S
authors.lastname: Egami
authors.forename: S
authors.initials: S
authors.lastname: Hishikawa
authors.forename: K
authors.initials: K
authors.lastname: Ushijima
authors.forename: S
authors.initials: S
authors.lastname: Otomo
authors.forename: K
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Yasuda
authors.forename: H
authors.initials: H
authors.lastname: Kawarasaki
mesh_terms: D001656:Biliary Atresia / Q000601:surgery*; D001783:Blood Flow Velocity; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008102:Liver Circulation; D016031:Liver Transplantation / Q000009:adverse effects; D019520:Living Donors; D008297:Male; D017082:Portal Pressure; D011169:Portal Vein / Q000503:physiopathology*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D012039:Regional Blood Flow; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography