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Conference Paper: Portal inflow and pressure changes in right liver living donor liver transplantation including middle hepatic vein

TitlePortal inflow and pressure changes in right liver living donor liver transplantation including middle hepatic vein
Authors
Issue Date2009
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021
Citation
The International Liver Transplantation Society: 15th Annual International Congress, New York City, N.Y., 8 - 11 July 2009. How to Cite?
AbstractThe middle hepatic vein may be included in the right liver graft in living donor liver transplantation (LDLT) to optimize hepatic venous outflow. We employed manometry of the portal system and ultrasonic flowmetry of graft inflow to study the graft’s ability in relieving portal hypertension and accommodating portal hyperperfusion. Possible correlation of the findings from such observations with surgical outcomes was investigated. The median ages of the recipients and donors of this 46 consecutive LDLT were 50 years (range, 16 to 66 years) and 31 years (range, 18 to 54 years), respectively. Graft to standard liver volume was 47.4% (range, 32.4 to 69.0%). The hospital mortality was 4.4% as two recipients had died from sepsis. Portal pressure dropped by 8 mmHg (range, -7 to 19 mmHg) from 23 mmHg (range, 8 to 37 mmHg) to 14 mmHg (range, 10 to 26 mmHg) after LDLT. Portal infl ow had a positive correlation with portal pressure before native liver hepatectomy (R2 = 0.305) (p = 0.000) and not graft size. Portal flow of the right liver increased from 81 mL/min/100 g (range, 35 to 210 mL/min/100 g) before donor right hepatectomy to 318 mL/min/100 g (range, 102 to 754 mL/min/100 g) after graft implantation. Graft portal flow had a linear correlation with the recipient portal pressure before hepatectomy of the native liver (R2 = 0.261) (p = 0.000) and graft to standard liver volume ratio (R2 = 0.247) (p = 0.000). The correlation was clearer with reference to a quotient derived from the recipient portal pressure divided by the graft to standard liver volume ratio (R2 = 0.381) (p = 0.000). The loss of such correlation with the portal pressure after graft implantation refl ected relief of the portal hypertension by graft implantation. Despite the high portal inflow after implantation, only one of the graft biopsies after implantation showed sinusoidal congestion of moderate severity. Complications of Clavien Grade 2 or above occurred in 12 recipients and were not related to the portal flow and pressure or their changes. Right liver LDLT including the middle hepatic vein effectively lowered the recipient portal pressure by allowing unimpeded venous outflow.
DescriptionLiver Transplantation, 2009, v. 15 n. Suppl 7, p. S92, Abstract no. O-67
Persistent Identifierhttp://hdl.handle.net/10722/107469
ISSN
2015 Impact Factor: 3.951
2015 SCImago Journal Rankings: 1.763

 

DC FieldValueLanguage
dc.contributor.authorChan, SCen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorNg, KKCen_HK
dc.contributor.authorChok, KSHen_HK
dc.contributor.authorYong, BHen_HK
dc.contributor.authorFan, STen_HK
dc.date.accessioned2010-09-25T23:58:56Z-
dc.date.available2010-09-25T23:58:56Z-
dc.date.issued2009en_HK
dc.identifier.citationThe International Liver Transplantation Society: 15th Annual International Congress, New York City, N.Y., 8 - 11 July 2009.en_HK
dc.identifier.issn1527-6465-
dc.identifier.urihttp://hdl.handle.net/10722/107469-
dc.descriptionLiver Transplantation, 2009, v. 15 n. Suppl 7, p. S92, Abstract no. O-67-
dc.description.abstractThe middle hepatic vein may be included in the right liver graft in living donor liver transplantation (LDLT) to optimize hepatic venous outflow. We employed manometry of the portal system and ultrasonic flowmetry of graft inflow to study the graft’s ability in relieving portal hypertension and accommodating portal hyperperfusion. Possible correlation of the findings from such observations with surgical outcomes was investigated. The median ages of the recipients and donors of this 46 consecutive LDLT were 50 years (range, 16 to 66 years) and 31 years (range, 18 to 54 years), respectively. Graft to standard liver volume was 47.4% (range, 32.4 to 69.0%). The hospital mortality was 4.4% as two recipients had died from sepsis. Portal pressure dropped by 8 mmHg (range, -7 to 19 mmHg) from 23 mmHg (range, 8 to 37 mmHg) to 14 mmHg (range, 10 to 26 mmHg) after LDLT. Portal infl ow had a positive correlation with portal pressure before native liver hepatectomy (R2 = 0.305) (p = 0.000) and not graft size. Portal flow of the right liver increased from 81 mL/min/100 g (range, 35 to 210 mL/min/100 g) before donor right hepatectomy to 318 mL/min/100 g (range, 102 to 754 mL/min/100 g) after graft implantation. Graft portal flow had a linear correlation with the recipient portal pressure before hepatectomy of the native liver (R2 = 0.261) (p = 0.000) and graft to standard liver volume ratio (R2 = 0.247) (p = 0.000). The correlation was clearer with reference to a quotient derived from the recipient portal pressure divided by the graft to standard liver volume ratio (R2 = 0.381) (p = 0.000). The loss of such correlation with the portal pressure after graft implantation refl ected relief of the portal hypertension by graft implantation. Despite the high portal inflow after implantation, only one of the graft biopsies after implantation showed sinusoidal congestion of moderate severity. Complications of Clavien Grade 2 or above occurred in 12 recipients and were not related to the portal flow and pressure or their changes. Right liver LDLT including the middle hepatic vein effectively lowered the recipient portal pressure by allowing unimpeded venous outflow.-
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021-
dc.relation.ispartofLiver Transplantationen_HK
dc.rightsLiver Transplantation. Copyright © John Wiley & Sons, Inc.-
dc.rightsSpecial Statement for Preprint only Before publication: 'This is a preprint of an article accepted for publication in [The Journal of Pathology] Copyright © ([year]) ([Pathological Society of Great Britain and Ireland])'. After publication: the preprint notice should be amended to follows: 'This is a preprint of an article published in [include the complete citation information for the final version of the Contribution as published in the print edition of the Journal]' For Cochrane Library/ Cochrane Database of Systematic Reviews, add statement & acknowledgement : ‘This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 20XX, Issue X. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.’ Please include reference to the Review and hyperlink to the original version using the following format e.g. Authors. Title of Review. Cochrane Database of Systematic Reviews 20XX, Issue #. Art. No.: CD00XXXX. DOI: 10.1002/14651858.CD00XXXX (insert persistent link to the article by using the URL: http://dx.doi.org/10.1002/14651858.CD00XXXX) (This statement should refer to the most recent issue of the Cochrane Database of Systematic Reviews in which the Review published.)-
dc.titlePortal inflow and pressure changes in right liver living donor liver transplantation including middle hepatic veinen_HK
dc.typeConference_Paperen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1527-6465&volume=15&issue=Suppl 7&spage=S92, Abstract no. O&epage=67&date=2009&atitle=Portal+inflow+and+pressure+changes+in+right+liver+living+donor+liver+transplantation+including+middle+hepatic+vein-
dc.identifier.emailChan, SC: chanlsc@HKUCC.hku.hken_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailNg, KKC: kkcng@HKUCC.hku.hken_HK
dc.identifier.emailYong, BH: bhyong@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.authorityChan, SC=rp01568en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.doi10.1002/lt.21830-
dc.identifier.hkuros162017en_HK
dc.identifier.hkuros170113-
dc.identifier.volume15en_HK
dc.identifier.issueSuppl 7en_HK
dc.identifier.spageS92, Abstract no. O-67en_HK
dc.identifier.epageS92, Abstract no. O-67-

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