Hepatic Vein Flow Index During Orthotopic Liver Transplantation as a Predictive Factor for Postoperative Early Allograft Dysfunction
| Autor: | Taro Kariya, Shunji Nagai, Kenichi A. Tanaka, Yoshihisa Morita, Ahmad Itani, Michael Isley |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Graft dysfunction Orthotopic liver transplantation 030204 cardiovascular system & hematology Hepatic Veins Graft function 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology medicine Humans Postoperative Period Prospective Studies Systole Vein business.industry Orthotopic Liver Transplant Allografts Predictive factor Surgery Liver Transplantation Clinical trial surgical procedures operative Anesthesiology and Pain Medicine medicine.anatomical_structure Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of cardiothoracic and vascular anesthesia. 35(11) |
| ISSN: | 1532-8422 |
| Popis: | The authors devised a hepatic vein flow index (HVFi), using intraoperative transesophageal echocardiography and graft weight, and investigated its predictive value for postoperative graft function in orthotopic liver transplant.Prospective clinical trial.Single-center tertiary academic hospital.Ninety-seven patients who had orthotopic liver transplant with the piggy-back technique between February 2018 and December 2019.HVFi was defined with HV flow/graft weight. Patients who developed early graft dysfunction (EAD) had low HVFi in systole (HVFi sys, 1.23 v 2.19 L/min/kg, p0.01), low HVFi in diastole (HVFi dia, 0.87 v 1.54 L/min/kg, p0.01), low hepatic vein flow (HVF) in systole (HVF sys, 2.04 v 3.95 L/min, p0.01), and low HVF in diastole (HVF dia, 1.44 v 2.63 L/min, p0.01). More cardiac death, more vasopressors at the time of measurement, more acute rejection, longer time to normalize total bilirubin (TIME t-bil), longer surgery time, longer neohepatic time, and more packed red blood cell transfusion were observed in the EAD patients. All HVF parameters were negatively correlated with TIME t-bil (HVFi sys R = -0.406, p0.01; HFVi dia R = -0.442, p0.01; HVF sys R = -0.44, p0.01; HVF dia R = -0.467, p0.01). The receiver operating characteristic curve analysis determined the best cut-off levels of HVFi to predict occurrence of EAD (HVFi sys1.608, HVFi dia0.784 L/min/kg), acute rejection (HVFi sys1.388, HVFi dia1.077 L/min/kg), and prolonged high total bilirubin (HVFi sys1.471, HVFi dia1.087 L/min/kg).The authors' devised HVFi has the potential to predict the postoperative graft function. |
| Databáze: | OpenAIRE |
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