Abstract
The portal vein flow (PVF), portal vein pressure (PVP), and hepatic venous pressure gradient (HVPG) were prospectively assessed to explore their relationships and to better define hyperflow and portal hypertension (PHT) during liver transplantation (LT). Eighty-one LT procedures were analyzed. No correlation between PVF and PVP was observed. Increases in the central venous pressure (CVP) were transmitted to the PVP (58%, range = 25%-91%, P = 0.001). Severe PHT (HVPG â?¥ 15 mm Hg) showed a significant reciprocal association with high PVF (P = 0.023) and lower graft survival (P = 0.04). According to this initial experience, an HVPG value â?¥ 15 mm Hg is a promising tool for the evaluation of hemodynamic stress potentially influencing outcomes. An algorithm for graft inflow modulation based on flows, gradients, and systemic hemodynamics is provided. In conclusion, the evaluation of PHT severity with PVP could be delusive because of the influence of CVP. PVF and PVP do not correlate and should not be used individually to assess hyperflow and PHT during LT.
| Original language | English |
|---|---|
| Pages (from-to) | 836-848 |
| Number of pages | 13 |
| Journal | Liver Transplantation |
| Volume | 17 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Jul 2011 |
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ASJC Scopus subject areas
- Surgery
- Transplantation
- Hepatology
Cite this
Lack of a correlation between portal vein flow and pressure : Toward a shared interpretation of hemodynamic stress governing inflow modulation in liver transplantation. / Sainz-Barriga, Mauricio; Scudeller, Luigia; Costa, Maria Gabriella; De Hemptinne, Bernard; Troisi, Roberto Ivan.
In: Liver Transplantation, Vol. 17, No. 7, 07.2011, p. 836-848.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Lack of a correlation between portal vein flow and pressure
T2 - Toward a shared interpretation of hemodynamic stress governing inflow modulation in liver transplantation
AU - Sainz-Barriga, Mauricio
AU - Scudeller, Luigia
AU - Costa, Maria Gabriella
AU - De Hemptinne, Bernard
AU - Troisi, Roberto Ivan
PY - 2011/7
Y1 - 2011/7
N2 - The portal vein flow (PVF), portal vein pressure (PVP), and hepatic venous pressure gradient (HVPG) were prospectively assessed to explore their relationships and to better define hyperflow and portal hypertension (PHT) during liver transplantation (LT). Eighty-one LT procedures were analyzed. No correlation between PVF and PVP was observed. Increases in the central venous pressure (CVP) were transmitted to the PVP (58%, range = 25%-91%, P = 0.001). Severe PHT (HVPG â?¥ 15 mm Hg) showed a significant reciprocal association with high PVF (P = 0.023) and lower graft survival (P = 0.04). According to this initial experience, an HVPG value â?¥ 15 mm Hg is a promising tool for the evaluation of hemodynamic stress potentially influencing outcomes. An algorithm for graft inflow modulation based on flows, gradients, and systemic hemodynamics is provided. In conclusion, the evaluation of PHT severity with PVP could be delusive because of the influence of CVP. PVF and PVP do not correlate and should not be used individually to assess hyperflow and PHT during LT.
AB - The portal vein flow (PVF), portal vein pressure (PVP), and hepatic venous pressure gradient (HVPG) were prospectively assessed to explore their relationships and to better define hyperflow and portal hypertension (PHT) during liver transplantation (LT). Eighty-one LT procedures were analyzed. No correlation between PVF and PVP was observed. Increases in the central venous pressure (CVP) were transmitted to the PVP (58%, range = 25%-91%, P = 0.001). Severe PHT (HVPG â?¥ 15 mm Hg) showed a significant reciprocal association with high PVF (P = 0.023) and lower graft survival (P = 0.04). According to this initial experience, an HVPG value â?¥ 15 mm Hg is a promising tool for the evaluation of hemodynamic stress potentially influencing outcomes. An algorithm for graft inflow modulation based on flows, gradients, and systemic hemodynamics is provided. In conclusion, the evaluation of PHT severity with PVP could be delusive because of the influence of CVP. PVF and PVP do not correlate and should not be used individually to assess hyperflow and PHT during LT.
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U2 - 10.1002/lt.22295
DO - 10.1002/lt.22295
M3 - Article
C2 - 21384528
AN - SCOPUS:79959851456
VL - 17
SP - 836
EP - 848
JO - Liver Transplantation
JF - Liver Transplantation
SN - 1527-6465
IS - 7
ER -