scholarly journals Hemodynamics and vasoactive substance levels during renal congestion that occurs in the anhepatic phase of liver transplantation

2015 ◽  
Vol 21 (18) ◽  
pp. 5482 ◽  
Author(s):  
Zhong-Xin Li
Keyword(s):  
Liver Transplantation ◽  
Vasoactive Substance ◽  
Anhepatic Phase

Evolution of Urokinase-Type Plasminogen Activator (u-PA) and Tissue-Type Plasminogen Activator (t-PA) in Orthotopic Liver Transplantation (OLT)

1993 ◽  
Vol 69 (01) ◽  
pp. 056-059 ◽  
Author(s):  
G Himmelreich ◽  
G Dooijewaard ◽  
P Breinl ◽  
W O Bechstein ◽  
P Neuhaus ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Plasminogen Activator ◽  
Orthotopic Liver Transplantation ◽  
Tissue Type ◽  
Bleeding Complications ◽  
Activity Levels ◽  
Tissue Type Plasminogen Activator ◽  
Type Plasminogen Activator ◽  
Urokinase Type Plasminogen Activator ◽  
Anhepatic Phase

SummaryIn orthotopic liver transplantation (OLT) hyperfibrinolysis seems to be of causative importance for intra- and postoperative bleeding. Although recently hyperfibrinolysis has been successfully reduced by intraoperative aprotinin treatment, small increases of fibrinolysis still remain during OLT. Originally, tissue-type plasminogen activator (t-PA) was considered to be responsible for the increases, but the efficacy of aprotinin which inhibits besides plasmin also kallikrein and urokinase-type plasminogen activator (u-PA) suggested also a role for the intrinsic and contact system-dependent plasminogen activators. We investigated the role of u-PA. From 29 patients undergoing OLT with intraoperative aprotinin infusion arterial blood samples were taken at 7 different time points. The preoperative median values for u-PA antigen (u-PA Ag) and plasmin-activatable single-chain u-PA (scu-PA) levels, which were more than 2-fold above normal (both: p <0.01), decreased slightly during the preanhepatic phase and remained unchanged during the anhepatic phase. With reperfusion of the graft liver the two levels decreased significantly (p = 0.0003 and p = 0.006, respectively) to almost normal values, probably due to clearance by the graft liver. Active two-chain u-PA (tcu-PA) was preoperatively 2-fold above the detection limit, remained stable during the preanhepatic phase and increased 2-fold in the anhepatic phase (p = 0.0018). As expected tcu-PA also relapsed upon reperfusion, but to the preoperatively enhanced level, possibly caused by sustained activation of scu-PA by cathepsin B. t-PA activity levels were at the upper end of the normal range preoperatively, slightly increased during preanhepatic and anhepatic phases and decreased significantly with reperfusion. The increases in tcu-PA and t-PA activities during the anhepatic phase coincided with greatly increased fibrinolysis as demonstrated by thrombelastography, indicating that both u-PA and t-PA are involved in the development of fibrinolysis during OLT.One patient was excluded from statistical evaluations because preoperative u-PA Ag, scu-PA, tcu-PA and t-PA activity levels were much higher than in the other 28 patients. In the investigated group this patient was the only one with diffuse peritonitis intraoperatively and severe bleeding complications postoperatively which made retransplantation mandatory.

Increased fibrinolysis in orthotopic but not in heterotopic liver transplantation: the role of the anhepatic phase

1992 ◽  
Vol 5 ◽  
pp. S173-S174
Author(s):  
C. M. Bakker ◽  
H. J. Metselaar ◽  
Th. N. Groenland ◽  
O. T. Terpstra ◽  
J. Stibbe
Keyword(s):  
Liver Transplantation ◽  
Anhepatic Phase

scholarly journals A.283 Pulmonary metabolism of propofol in pigs during anhepatic phase of orthotopic liver transplantation

1996 ◽  
Vol 76 ◽  
pp. 89
Author(s):  
Zeynep Eti ◽  
Tümay Umuroglu ◽  
Abdurrahman Yayci ◽  
Serpil Ustalar ◽  
F. Yilmaz Gögüç
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Anhepatic Phase

Utility of uncalibrated femoral stroke volume variation as a predictor of fluid responsiveness during the anhepatic phase of liver transplantation

2011 ◽  
Vol 17 (1) ◽  
pp. 53-59 ◽  
Author(s):  
Young Hee Shin ◽  
Justin Sangwook Ko ◽  
Mi Sook Gwak ◽  
Gaab Soo Kim ◽  
Jong Hwan Lee ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Stroke Volume ◽  
Fluid Responsiveness ◽  
Stroke Volume Variation ◽  
Volume Variation ◽  
Anhepatic Phase

scholarly journals METABOLIC CHANGES DURING THE ANHEPATIC PHASE OF LIVER TRANSPLANTATION

1984 ◽  
Vol 61 (3) ◽  
pp. A271-A271 ◽  
Author(s):  
William C. Tullock ◽  
Michael R. Pinsky ◽  
Byers Shaw ◽  
Douglas J. Martin
Keyword(s):  
Liver Transplantation ◽  
Metabolic Changes ◽  
Anhepatic Phase

141Non-hepatic glucose production in humans during the anhepatic phase of liver transplantation

2000 ◽  
Vol 6 (3) ◽  
pp. C35-C35
Author(s):  
A PULVIRENTI ◽  
J COPPA ◽  
A BATTEZZATI ◽  
L LUZI ◽  
D MATTHEWS ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatic Glucose Production ◽  
Glucose Production ◽  
Hepatic Glucose ◽  
Anhepatic Phase

scholarly journals Intraoperative Hepatic Blood Inflow Can Predict Early Acute Kidney Injury following DCD Liver Transplantation: A Retrospective Observational Study

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Ao Jiao ◽  
Qingpeng Liu ◽  
Feng Li ◽  
Rui Guo ◽  
Bowen Wang ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Acute Kidney Injury ◽  
Prediction Model ◽  
Prediction Models ◽  
Validation Cohort ◽  
Kidney Injury ◽  
Clinical Usefulness ◽  
Anhepatic Phase ◽  
Blood Inflow ◽  
Ctp Score

Purpose. Acute kidney injury (AKI) is a major and severe complication following donation-after-circulatory-death (DCD) liver transplantation (LT) and is associated with increased postoperative morbidity and mortality. However, the risk factors and the prognosis factors of AKI still need to be further explored, and the relativity of intraoperative hepatic blood inflow (HBI) and AKI following LT has not been discussed yet. The purpose of this study was to investigate the correlation between HBI and AKI and to construct a prediction model of early acute kidney injury (EAKI) following DCD LT with the combination of HBI and other clinical parameters. Methods. Clinical data of 132 patients who underwent DCD liver transplantation at the first hospital of China Medical University from April 2005 to March 2017 were analyzed. Data of 105 patients (the first ten years of patients) were used to develop the prediction model. Then we assessed the clinical usefulness of the prediction models in the validation cohort (27 patients). EAKI according to Kidney Disease Improving Global Outcomes (KDIGO) criteria based on serum creatinine increase during 7-day of postoperative follow-up. Results. After Least Absolute Shrinkage and Selection Operator (LASSO) regression and simplification, a simplified prediction model consisting of the Child-Turcotte-Pugh (CTP) score (p=0.033), anhepatic phase (p=0.014), packed red blood cell (pRBC) transfusion (p=0.027), and the HBI indexed by height (HBI/h) (p=0.002) was established. The C-indexes of the model in the development and validation cohort were 0.823 [95% CI, 0.738-0.908] and 0.921 [95% CI, 0.816-1.000], respectively. Conclusions. In this study, we demonstrated the utility of HBI/h as a predictor for EAKI following DCD LT, as well as the clinical usefulness of the prediction model through the combination of the CTP score, anhepatic phase, pRBC transfusion and HBI/h.

scholarly journals Hemodynamics alterations during orthotopic liver experimental transplantation in pigs

2008 ◽  
Vol 23 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Orlando Jorge Martins Torres ◽  
Patrícia Brandão Pantoja ◽  
Erica Sampaio Barbosa ◽  
Cristiany de Almeida Barros ◽  
Elizabeth Teixeira Noguera Servin ◽  
...  
Keyword(s):  
Heart Rate ◽  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Venous Pressure ◽  
Systemic Arterial Pressure ◽  
Blood Gas ◽  
Cold Ischemia ◽  
Central Venous ◽  
Anhepatic Phase ◽  
The Mean

PURPOSE: To describe the hemodynamics alterations during orthotopic liver transplantation in pigs. METHODS: In the period from April 2004 to December 2005, forty-four female Landrace pigs, weighting between 32 and 38 Kg were undergone to orthotopic liver transplantation. The animals were divided into two groups, donor and recipient pairs, which received whole liver grafts. The surgical procedure was divided into four parts: harvested, back-table, hepatectomy of the recipient and implantation. We analyze heart rate, blood gas, mean systemic arterial pressure (MAP-mmHg), central venous pressure, pH, Na-, K+, Cl-, Ca+ and urinary output. RESULTS: The mean anhepatic time was 69 min, cold ischemia was 252.2 min and back-table was 56.6 min. Blood pressure and heart rate dropped significantly during anhepatic phase and after revascularization. Blood gas and electrolytes alterations were observed during anhepatic and reperfusion phases. Although alterations were noted during these phases, the hemodynamic status was recovered and stabilized in the end of the surgery. CONCLUSIONS: Simplified technique of liver transplant was achieved and description of hemodynamic alterations was possible in pigs.

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