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The postoperative hepatic artery resistance index after living donor liver transplantation can predict early allograft dysfunction

To investigate whether postoperative hepatic hemodynamics have an impact on graft function. Using a retrospective cohort with 262 adult living donor liver transplantation (LDLT) recipients, we discussed the relationship between postoperative hepatic hemodynamics and patient outcomes. According to th...

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Autores principales: Lv, Tao, Kong, LingXiang, Yang, Jiayin, Wu, Hong, Wen, Tianfu, Jiang, Li, Yang, Jian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004676/
https://www.ncbi.nlm.nih.gov/pubmed/31977857
http://dx.doi.org/10.1097/MD.0000000000018677
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author Lv, Tao
Kong, LingXiang
Yang, Jiayin
Wu, Hong
Wen, Tianfu
Jiang, Li
Yang, Jian
author_facet Lv, Tao
Kong, LingXiang
Yang, Jiayin
Wu, Hong
Wen, Tianfu
Jiang, Li
Yang, Jian
author_sort Lv, Tao
collection PubMed
description To investigate whether postoperative hepatic hemodynamics have an impact on graft function. Using a retrospective cohort with 262 adult living donor liver transplantation (LDLT) recipients, we discussed the relationship between postoperative hepatic hemodynamics and patient outcomes. According to the definition of early allograft dysfunction (EAD), the patients were classified into the EAD group (43 patients) and the non-EAD group (219 patients). In terms of postoperative hemodynamic parameters, there was no significant differences between these 2 groups regarding hepatic artery flow (HAF), hepatic artery velocity (HAV), portal vein flow (PVF), and portal vein velocity (PVV), except for the hepatic artery resistance index (HARI) which was somewhat higher in the EAD group on postoperative day 3 (POD3) (0.70 vs 0.61, P < .05). According to these results, we used a ROC curve and found that a HARI of 0.68 was the cutoff point (with 73.8% sensitivity and 58.3% specificity) for predicting EAD after LDLT. In addition, multivariate analysis showed that fulminant hepatic failure, pretransplant hepatorenal syndrome, and HARI ≥ 0.68 on POD3 were independent risk factors for postoperative EAD. Our results showed that postoperative hemodynamics might influence graft function by altering hepatic artery flow.
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spelling pubmed-70046762020-02-18 The postoperative hepatic artery resistance index after living donor liver transplantation can predict early allograft dysfunction Lv, Tao Kong, LingXiang Yang, Jiayin Wu, Hong Wen, Tianfu Jiang, Li Yang, Jian Medicine (Baltimore) 4500 To investigate whether postoperative hepatic hemodynamics have an impact on graft function. Using a retrospective cohort with 262 adult living donor liver transplantation (LDLT) recipients, we discussed the relationship between postoperative hepatic hemodynamics and patient outcomes. According to the definition of early allograft dysfunction (EAD), the patients were classified into the EAD group (43 patients) and the non-EAD group (219 patients). In terms of postoperative hemodynamic parameters, there was no significant differences between these 2 groups regarding hepatic artery flow (HAF), hepatic artery velocity (HAV), portal vein flow (PVF), and portal vein velocity (PVV), except for the hepatic artery resistance index (HARI) which was somewhat higher in the EAD group on postoperative day 3 (POD3) (0.70 vs 0.61, P < .05). According to these results, we used a ROC curve and found that a HARI of 0.68 was the cutoff point (with 73.8% sensitivity and 58.3% specificity) for predicting EAD after LDLT. In addition, multivariate analysis showed that fulminant hepatic failure, pretransplant hepatorenal syndrome, and HARI ≥ 0.68 on POD3 were independent risk factors for postoperative EAD. Our results showed that postoperative hemodynamics might influence graft function by altering hepatic artery flow. Wolters Kluwer Health 2020-01-24 /pmc/articles/PMC7004676/ /pubmed/31977857 http://dx.doi.org/10.1097/MD.0000000000018677 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 4500
Lv, Tao
Kong, LingXiang
Yang, Jiayin
Wu, Hong
Wen, Tianfu
Jiang, Li
Yang, Jian
The postoperative hepatic artery resistance index after living donor liver transplantation can predict early allograft dysfunction
title The postoperative hepatic artery resistance index after living donor liver transplantation can predict early allograft dysfunction
title_full The postoperative hepatic artery resistance index after living donor liver transplantation can predict early allograft dysfunction
title_fullStr The postoperative hepatic artery resistance index after living donor liver transplantation can predict early allograft dysfunction
title_full_unstemmed The postoperative hepatic artery resistance index after living donor liver transplantation can predict early allograft dysfunction
title_short The postoperative hepatic artery resistance index after living donor liver transplantation can predict early allograft dysfunction
title_sort postoperative hepatic artery resistance index after living donor liver transplantation can predict early allograft dysfunction
topic 4500
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004676/
https://www.ncbi.nlm.nih.gov/pubmed/31977857
http://dx.doi.org/10.1097/MD.0000000000018677
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