title: [Hemodynamic monitoring protocol during living donor liver transplantation].
abstract: BACKGROUND
  The recipient of an adult living donor liver transplant (ALDLT) is subjected to great haemodynamic changes that could lead to the appearance of a "small-for-size" syndrome in the post-operative period due to portal hyperflow. The aim of this article is to evaluate these changes, and try to correlate them with portal vein flow during reperfusion.
  
  
  METHODS
  A protocol for monitoring various liver haemodynamic data of the ALDLT recipient before, during and after surgery has been used since the year 2003. The haemodynamic outcome of the recipient after the transplant, as well as the correlation between the portal vein flow during reperfusion and the collected haemodynamic data is analysed.
  
  
  RESULTS
  There was no small for size syndrome. A significant relationship was found between the portal flow during reperfusion and the portal vein pressure at the beginning of the operation (r=0.46, P<.006) and with the portocaval shunt flow during the anhepatic phase (r=0.55, P<.001). The recipients showed a normal splanchnic hemodynamic state at 3 months after the transplant.
  
  
  CONCLUSIONS
  Haemodynamic monitoring of the ALDLT recipient is essential to prevent portal hyperflow. The relationship between flow during reperfusion and flow through the portocaval shunt means that patients with a higher risk of hyperflow can be identified and can be modified before reperfusion.
authors.affiliation: Unidad de Cirugía Hepática y Trasplante, Hospital Clínic de Barcelona, Barcelona, España.
authors.forename: Santiago
authors.initials: S
authors.lastname: Sánchez Cabús
authors.forename: David
authors.initials: D
authors.lastname: Calatayud
authors.forename: Constantino
authors.initials: C
authors.lastname: Fondevila
authors.forename: Joana
authors.initials: J
authors.lastname: Ferrer
authors.forename: José
authors.initials: J
authors.lastname: Fuster
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: García-Valdecasas
mesh_terms: D002985:Clinical Protocols; D005260:Female; D006439:Hemodynamics; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D011169:Portal Vein / Q000502:physiology*; D012039:Regional Blood Flow; D012189:Retrospective Studies