Perioperative Plasma Concentrations of Endothelin and Natriuretic Peptides in Children Undergoing Living-Related Liver Transplantation
| Autor: | Kazuwa Nakao, Kenjiro Mori, Tatsuo Magaribuchi, Shin Ichi Suga, Tsutomu Shichino, Masahiro Murakawa, Toyohiko O'higashi, Susumu Mashima, Gotaro Shirakami, Koh Shingu |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Cirrhosis medicine.medical_treatment Blood Pressure Nerve Tissue Proteins Liver transplantation Plasma renin activity Renin-Angiotensin System chemistry.chemical_compound Atrial natriuretic peptide Biliary Atresia Internal medicine Natriuretic Peptide Brain Renin Renin–angiotensin system medicine Humans Postoperative Period Child Aldosterone business.industry Endothelins Infant medicine.disease Brain natriuretic peptide Tissue Donors Liver Transplantation Transplantation Anesthesiology and Pain Medicine Endocrinology chemistry Child Preschool Reperfusion Female business Atrial Natriuretic Factor |
| Zdroj: | Anesthesia & Analgesia. 82:235-240 |
| ISSN: | 0003-2999 |
| Popis: | To investigate the clinical significance of endothelin (ET), natriuretic peptides, and the renin-angiotensin-aldosterone system in pediatric liver transplantation, we measured plasma levels of ET, atrial and brain natriuretic peptides (ANP, BNP), aldosterone, and plasma renin activity in 18 patients (aged 0.5-12 yr; median 1 yr) undergoing living-related liver transplantation due to congenital biliary atresia and severe liver cirrhosis. Before transplantation, the plasma ET level (28.9 +/- 2.5 [mean +/- SEM] pg/mL) was increased compared with that of healthy children (10-18 pg/mL), but decreased during the anhepatic phase (22.5 +/- 1.6 pg/mL). It increased again after reperfusion and remained at high levels in the early postoperative period (postoperative day 3, 27.8 +/- 3.0 pg/mL). Plasma levels of ANP and BNP and aldosterone and plasma renin activity were also high before surgery. Plasma ANP and BNP did not change significantly during surgery. After transplantation, plasma BNP significantly increased, and plasma ANP tended to increase. Plasma aldosterone increased markedly during the anhepatic phase, although plasma renin activity decreased. After transplantation, plasma aldosterone and plasma renin activity both decreased to within normal levels. Mean arterial blood pressure increased gradually after reperfusion and surgery (postoperative day 3, 35.7 +/- 5.2% increase). No substantial differences in these variables occurred between the younger (or = 1.0 yr, n = 9) and older patients (1.0 yr, n = 9). These results suggest that ET production in the cirrhotic liver is augmented and ET, natriuretic peptides, and the renin-angiotensin-aldosterone system all play some role in the circulatory regulation during perioperative periods of pediatric liver transplantation. |
| Databáze: | OpenAIRE |
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