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

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

ASJC Scopus subject areas

  • Surgery
  • Transplantation
  • Hepatology

Fingerprint Dive into the research topics of 'Lack of a correlation between portal vein flow and pressure: Toward a shared interpretation of hemodynamic stress governing inflow modulation in liver transplantation'. Together they form a unique fingerprint.

Cite this