SPLANCHNIC HYPEREMIA AFTER LIVER-TRANSPLANTATION IN PATIENTS WITH END-STAGE LIVER-DISEASE

Systemic and splanchnic hemodynamic parameters were evaluated in 12 pa tients with cirrhosis before and 3 and 6 months after liver transplant ation, Results were compared with those obtained in 8 healthy subjects . Three months after liver transplantation recipients had an increase in mean arterial pressure(98 +/- 7 v78 +/- 9 mmHg; P <.05), an insigni ficant decrease in cardiac index (3.4 +/- 0.6 v4.0 +/- 1.0 L . min(-1) . m(-2)), and a marked increase in peripheral vascular resistance (1, 563 +/- 308 v800 +/- 205 dyne . s . cm(-5); P <.05) compared with pret ransplantation values. Portal blood flow was also significantly increa sed (1,494 +/- 200 v829 +/- 130 mL/min; P <.05). These hemodynamic cha nges were more pronounced 6 months after transplantation (mean arteria l pressure, 100 +/- 8 mmHg; cardiac index, 3.0 +/-1.0 L . min(-1) . m( -2); P <.01; peripheral vascular resistance, 1,680 +/- 405 dyne . s . cm(-5); portal blood flow, 1,520 +/- 180 mL/min), Systemic hemodynamic s 6 months after liver transplantation were similar to those observed in the healthy control group (mean arterial pressure, 95 +/- 6 mmHg; c ardiac index, 2.9 +/- 0.9 L . min(-1) . m(-2); peripheral vascular res istance, 1,480 +/- 380 dyne . s . cm(-5)), However, portal blood flow was still significantly higher than in healthy controls at 6 months (1 ,520 ct: 180 v910 +/- 140 mL/min; P <.05). This study shows that syste mic hemodynamics are normalized after liver transplantation. However, an increase In portal blood flow occurs and persists for at least 6 mo nths after liver transplantation, Further studies are needed to clarif y the cause of the abnormally high portal flows. Copyright (C) 1998 by the American Association for the Study of Liver Diseases.