title: Hepatic Arterial Buffer Response Maintains the Homeostasis of Graft Hemodynamics in Patient Receiving Living Donor Liver Transplantation.
abstract: BACKGROUND
  In living donor liver transplantation (LDLT), the hepatic hemodynamics plays important roles in graft regeneration, and the hepatic blood inflows are associated with graft size. However, the data of interplay between the hepatic arterial buffer response (HABR) and graft-to-recipient weight ratio (GRWR) in clinical LDLT are lacking.
  
  
  OBJECTIVE
  To identify the effect of the HABR on the hepatic hemodynamics and recovery of graft function and to evaluate the safe lower limit of the GRWR in carefully selected recipients.
  
  
  METHODS
  Portal venous and hepatic arterial blood flow was measured in recipients with ultrasonography, and the graft functional recovery, various complications, and survive states after LDLT were compared.
  
  
  RESULTS
  In total, 246 consecutive patients underwent LDLT with right lobe grafts. In total, 26 had a GRWR < 0.7 % (A), 29 had a GRWR between 0.7 and 0.8 % (B), and 181 had a GRWR > 0.8 % (C). For small-for-size syndrome, there was no significant difference (P = 0.176). Graft survival rates at 1, 3, and 5 year were not different (P = 0.710). The portal vein flow and portal vein flow per 100 g graft weight peaks were significantly higher in the A. Hepatic arterial velocity and hepatic arterial flow decreased in all the three groups on postoperative day 1; however, the hepatic arterial flow per 100 g graft weight was close to healthy controls.
  
  
  CONCLUSIONS
  HABR played important roles not only in the homeostasis of hepatic afferent blood supply but also in maintaining enough hepatic perfusion to the graft.
authors.affiliation: Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. Westchina_lc@foxmail.com.|Center of Interventional Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China. Westchina_lc@foxmail.com.
authors.forename: Chang
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. songjiulin1990@qq.com.
authors.forename: Jiu-lin
authors.initials: JL
authors.lastname: Song
authors.affiliation: Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. Luwu8@126.com.
authors.forename: Wu-sheng
authors.initials: WS
authors.lastname: Lu
authors.affiliation: Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. docjackyang@163.com.
authors.forename: Jia-yin
authors.initials: JY
authors.lastname: Yang
authors.affiliation: Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. Jl339@126.com.
authors.forename: Li
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. Yanlunan688@163.com.
authors.forename: Lu-nan
authors.initials: LN
authors.lastname: Yan
authors.affiliation: Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. 51219038@qq.com.
authors.forename: Jing-yi
authors.initials: JY
authors.lastname: Zhang
authors.affiliation: Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. 1915968289@qq.com.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Lu
authors.affiliation: Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. ccwentianfu@sohu.com.
authors.forename: Tian-fu
authors.initials: TF
authors.lastname: Wen
authors.affiliation: Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. xumingqing0018@163.com.
authors.forename: Ming-qing
authors.initials: MQ
authors.lastname: Xu
authors.affiliation: Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. wwt02@163.com.
authors.forename: Wen-tao
authors.initials: WT
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D005260:Female; D006085:Graft Survival; D006439:Hemodynamics; D006499:Hepatic Artery / Q000502:physiology*; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D008099:Liver / Q000098:blood supply*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000502:physiology; D055815:Young Adult
keywords: Graft-to-recipient weight ratio; Hemodynamics; Hepatic arterial buffer response; Liver transplantation