RELATIONSHIP BETWEEN SYSTEMIC PROSTAGLAND IN LEVELS AND HEMODYNAMIC-ALTERATIONS DURING ORTHOTOPIC LIVER-TRANSPLANTATION

The aim of this study is to investigate the role of prostaglandins (PG I(2) and TXA(2)) in relation with the hemodynamic alterations occuring after graft reperfusion in patients undergoing OLT. A total of 40 pat ients with liver cirrhosis were studied. Systemic 6-keto-PGF(1 alpha) and TXB(2), stable metabolites of PGI(2) and TXA(2) respectively, were determined at the radial artery, at four different surgical stages: b asal, hepatectomy, anhepatic, and 10 minutes after graft reperfusion, Overall results showed that 6-keto-PGF(1 alpha) levels were significan tly elevated during hepatectomy (1143 +/- 204) when compared to values in the basal stage (p = 0.007). During hepatectomy, 6-keto-PGF(1 alph a) levels did not correlate to systemic vascular resistance index (SVR I), neither with the cardiac index (IC) nor with the medial arterial p ressure (MAP) in the same stage. During the anhepatic stage, only IRVS was inversely correlated with 6-keto-PGF(1 alpha) levels (p = 0.004): there was no relation with MAP and CI. During reperfusion no correlat ions were observed between 6-keto-PGF(1 alpha) levels and MAP, CI or S VRI. We conclude that systemic PGI(2) levels are very high in cirrhoti c patients undergoing OLT. The absence of correlation between the magn itude of changes in hemodynamic parameters and 6-keto-PGF(1 alpha) lev els during reperfusion of the new liver suggests that other factors mu st play a role in these hemodynamic changes.