title: Evaluation of esophagogastric varices after adult-to-adult living donor liver transplantation using a left lobe graft.
abstract: BACKGROUND
  There is little information on whether living donor liver transplantation (LDLT) reduces the supply of blood to esophagogastric varices. The aim of the present study was to assess the effects of LDLT on esophagogastric varices using both endoscopy and transendoscopic microvascular Doppler sonography (EMDS).
  
  
  METHODS
  16 LDLT recipients were enrolled in the present study. Esophagogastric varices were assessed by endoscopy before and after LDLT. Direct measurement of variceal blood velocity was performed using EMDS in 12 of the 16 patients, and portal vein pressure before and after graft implantation was measured in 10 of them.
  
  
  RESULTS
  The median interval between LDLT and endoscopic examination was 129 days (range 20-624). Endoscopy demonstrated improvement of esophageal varices in 15 patients and of gastric varices in 4 of 5 patients assessed. The mean blood flow velocity in esophageal varices after LDLT was significantly lower than that before LDLT (8.8 ± 3.6 vs. 0.9 ± 1.2 cm/s, p < 0.001). The mean portal vein pressure did not decrease significantly after LDLT in comparison with that before LDLT (from 25.2 ± 5.2 to 23.1 ± 3.6 mm Hg, p = 0.22).
  
  
  CONCLUSIONS
  Although portal vein pressure does not decrease immediately after left lobe LDLT, esophagogastric varices are ameliorated after a few months, and variceal blood flow velocity is reduced in almost all patients.
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ishizaki
authors.forename: Nanami
authors.initials: N
authors.lastname: Konishi
authors.forename: Jiro
authors.initials: J
authors.lastname: Yoshimoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sugo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imamura
authors.forename: Seiji
authors.initials: S
authors.lastname: Kawasaki
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D015331:Cohort Studies; D004932:Esophageal and Gastric Varices / Q000175:diagnosis* / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018617:Ultrasonography, Doppler, Pulsed; D055815:Young Adult