Lack of a correlation between portal vein flow and pressure: Toward a shared interpretation of hemodynamic stress governing inflow modulation in liver transplantation

Mauricio Sainz-Barriga, Luigia Scudeller, Maria Gabriella Costa, Bernard De Hemptinne, Roberto Ivan Troisi

Research output: Contribution to journalArticle

47 Citations (Scopus)

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 languageEnglish
Pages (from-to)836-848
Number of pages13
JournalLiver Transplantation
Volume17
Issue number7
DOIs
Publication statusPublished - Jul 2011

Fingerprint

Portal Pressure
Portal Vein
Liver Transplantation
Hemodynamics
Portal Hypertension
Venous Pressure
Central Venous Pressure
Liver
Graft Survival
Transplants

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 journalArticle

Sainz-Barriga, Mauricio ; Scudeller, Luigia ; Costa, Maria Gabriella ; De Hemptinne, Bernard ; Troisi, Roberto Ivan. / Lack of a correlation between portal vein flow and pressure : Toward a shared interpretation of hemodynamic stress governing inflow modulation in liver transplantation. In: Liver Transplantation. 2011 ; Vol. 17, No. 7. pp. 836-848.
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