کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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5664848 | 1591094 | 2017 | 12 صفحه PDF | دانلود رایگان |
BackgroundPortal hyperperfusion as a cause of small for size syndrome (SFSS) after living donor liver transplantation (LDLT) remains controversial. Portal venous pressure (PVP) is often measured indirectly and may be confounded by central venous pressure (CVP).MethodsIn 42 adult cirrhotics undergoing elective LDLT, PVP was measured by direct canulation of portal vein and porto systemic gradient (PSG) was obtained after subtracting CVP from PVP. None underwent portal inflow modulation. SFSS was looked in 27 patients after excluding 15 with technical complications.ResultsClinical features of SFSS found in 6 patients, 5 with graft recipient weight ratio (GRWR)Â >Â 0.8% and PVPÂ <Â 20Â mm of Hg. One with GRWRÂ <Â 0.8% could truly be labeled as SFSS. Incidence of SFSS was not higher in patients with elevated PVPÂ >Â 20Â mm of Hg (14.3% vs 0%, PÂ =Â 0.259) or PSGÂ >Â 13Â mm of Hg (33.3% vs 0%, PÂ =Â 0.111). Intensive care unit (ICU) stay was longer in patients with elevated PVP (14.55 vs 9.13 days, PÂ =Â 0.007) and PSG (16.8 vs 9.72 days, PÂ =Â 0.009). There was no difference in graft functions, post-operative complications and mortality in first month post-LDLT.ConclusionElevated PVP or PSG increased morbidity but neither predicted SFSS nor affected survival.
Journal: Journal of Clinical and Experimental Hepatology - Volume 7, Issue 3, September 2017, Pages 235-246