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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2010.3
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- 10 - 15 (6page)
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Purpose: Although living donor liver transplantations (LDLTs) are widely performed, a shortage of living donors exists continuously, which makes it difficult to find the optimal graft. A high portal venous pressure (PVP) is mainly related to small for size syndrome (SFSS), and low portal venous flow (PVF), to ischemic liver damage, leading to potential liver failure after surgery. We reviewed the literature in search of optimal PVP and PVF values during LDLTs, and tried to determine the clinical meaning of measurements of PVP and PVF for liver transplantation.
Methods: Between June, 2008 and June, 2009, we did 38 LDLTs. PVP and PVF were measured in 13 patients after laparotomy, after implantation of graft and after splenectomy. In addition, compliance (PVF/PVP) and compliance (mL/min/mmHg/g) per unit graft weight were calculated. Splenectomy was done when continuously maintained portal hypertension (>20 mmHg) occurred even after implantation. Splenectomy was also done for patients who presented preoperatively with splenomegaly and pancytopenia.
Results: After graft implantation, portal venous pressure decreased (16.8±4.1 mmHg vs. 14.7±3.1 mmHg)(p=.003), whereas portal venous flow increased (1236.4±725.3 mL/min vs. 1916.9±603 mL/min)(p=.019). Also, after splenectomy, portal venous pressure/flow decreased (16.4±3.7 mmHg vs. 13.8±3.3 mmHg)(p=.009)/(2136.4 mL/min vs. 1619.1±336.3 mL/min) (p=.001). Finally, after implantation, compliance increased (60±40 mL/min/mmHg vs. 126±18 mL/min/mmHg)(p=.007).
Conclusion: After splenectomy, compliance remained constant (126±18 mL/min/mmHg vs. 122±34 mL/min/mmHg)(p=.364). After implantation of the graft, portal pressure decreased and portal venous flow increased. The compliance of the graft was not influenced by splenectomy. This shows that splenectomy is a good method to control high portal pressure without influencing the compliance of the graft.
Methods: Between June, 2008 and June, 2009, we did 38 LDLTs. PVP and PVF were measured in 13 patients after laparotomy, after implantation of graft and after splenectomy. In addition, compliance (PVF/PVP) and compliance (mL/min/mmHg/g) per unit graft weight were calculated. Splenectomy was done when continuously maintained portal hypertension (>20 mmHg) occurred even after implantation. Splenectomy was also done for patients who presented preoperatively with splenomegaly and pancytopenia.
Results: After graft implantation, portal venous pressure decreased (16.8±4.1 mmHg vs. 14.7±3.1 mmHg)(p=.003), whereas portal venous flow increased (1236.4±725.3 mL/min vs. 1916.9±603 mL/min)(p=.019). Also, after splenectomy, portal venous pressure/flow decreased (16.4±3.7 mmHg vs. 13.8±3.3 mmHg)(p=.009)/(2136.4 mL/min vs. 1619.1±336.3 mL/min) (p=.001). Finally, after implantation, compliance increased (60±40 mL/min/mmHg vs. 126±18 mL/min/mmHg)(p=.007).
Conclusion: After splenectomy, compliance remained constant (126±18 mL/min/mmHg vs. 122±34 mL/min/mmHg)(p=.364). After implantation of the graft, portal pressure decreased and portal venous flow increased. The compliance of the graft was not influenced by splenectomy. This shows that splenectomy is a good method to control high portal pressure without influencing the compliance of the graft.
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참고문헌
참고문헌 (16)
참고문헌 신청
1. [학술지(정기간행물)] - Lee S / 2001 / Congestion of right liver graft in living donor liver transplantation / Transplantation 71 : 812 ~ 814
2. [학술지(정기간행물)] - Kiuchi T / 1999 / Impact of graft size mismatching on graft prognosis in liver transplantation from living donors / Transplantation 67 : 321 ~ 327
3. [학술지(정기간행물)] - Man K / 2003 / Graft injury in relation to graft size in right lobe live donor liver transplantation: a study of hepatic sinusoidal injury in correlation with portal hemodynamics and intragraft gene expression / Ann Surg 237 : 256 ~ 264
4. [학술지(정기간행물)] - Margarit C / 1999 / Liver transplantation in patients with splenorenal shunts: intraoperative flow measurements to indicate shunt occlusion / Liver Transpl Sung 5 : 35 ~ 39
5. [학술지(정기간행물)] - Yagi S / 2005 / Impact of portal venous pressure on regeneration and graft damage after living-donor liver transplantation / Liver Transpl 11 : 68 ~ 75
2. [학술지(정기간행물)] - Kiuchi T / 1999 / Impact of graft size mismatching on graft prognosis in liver transplantation from living donors / Transplantation 67 : 321 ~ 327
3. [학술지(정기간행물)] - Man K / 2003 / Graft injury in relation to graft size in right lobe live donor liver transplantation: a study of hepatic sinusoidal injury in correlation with portal hemodynamics and intragraft gene expression / Ann Surg 237 : 256 ~ 264
4. [학술지(정기간행물)] - Margarit C / 1999 / Liver transplantation in patients with splenorenal shunts: intraoperative flow measurements to indicate shunt occlusion / Liver Transpl Sung 5 : 35 ~ 39
5. [학술지(정기간행물)] - Yagi S / 2005 / Impact of portal venous pressure on regeneration and graft damage after living-donor liver transplantation / Liver Transpl 11 : 68 ~ 75
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UCI(KEPA) : I410-ECN-0101-2014-514-001278133