STUDIES OF PORTAL HEMODYNAMICS AND HEPATIC OXYGEN-CONSUMPTION DURING ACUTE LIVER ALLOGRAFT-REJECTION

Citation
A. Gadano et al., STUDIES OF PORTAL HEMODYNAMICS AND HEPATIC OXYGEN-CONSUMPTION DURING ACUTE LIVER ALLOGRAFT-REJECTION, Transplantation, 64(8), 1997, pp. 1188-1192
Citations number
23
Categorie Soggetti
Immunology,Surgery,Transplantation
Journal title
ISSN journal
00411337
Volume
64
Issue
8
Year of publication
1997
Pages
1188 - 1192
Database
ISI
SICI code
0041-1337(1997)64:8<1188:SOPHAH>2.0.ZU;2-P
Abstract
Hemodynamics and oxygen variables, plasma cytokines, and histological features of a liver tissue sample obtained by transvenous biopsy were evaluated during 65 episodes of acute rejection. The hepatic venous pr essure gradient was significantly higher in patients with acute reject ion than in those without (5.1+/-0.3 vs. 3.1+/-0.2 mmHg, P<0.01). The increase in pressure gradient was related to the severity of rejection lesions. Hepatic blood flow was significantly lower in patients with than in those without acute graft rejection (1.28+/-0.11 vs. 1.75+/-0. 13 L/min, P<0.05). Plasma interleukin-6 levels were significantly incr eased in patients with acute rejection and positively correlated with pressure gradient values. In patients with acute rejection, a signific ant decrease in hepatic venous oxygen content (-16%) was associated wi th a significant increase in hepatic oxygen consumption (+24%), wherea s hepatic oxygen transport did not change significantly. In treated pa tients with a favorable response, the pressure gradient decreased sign ificantly by 46%, but it remained elevated in patients who later devel oped chronic graft rejection. In conclusion, this study confirms that acute graft rejection may induce an increase in portal pressure, which is related to the severity of rejection lesions. It also shows that a cute rejection decreases hepatic blood flow and increases hepatic oxyg en consumption, In addition, it suggests that the hepatic venous press ure gradient might be useful to determine the outcome of rejection.