Graft Inflow Modulation in Living-Donor Liver Transplantation: Hepatic Hemodynamic Changes in Splenic Artery Ligation and Splenectomy

19 July 2022 : Original article

Che-Min Su^1ABCDEF, Tsung-Ching Chou^1ABD, Tsung-Han Yang^1ABD, Yih-Jyh Lin^1ABDEF*

DOI: 10.12659/AOT.936609

Ann Transplant 2022; 27:e936609

Background Material and Methods Results Discussion Conclusions References

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Table 2 Operative characteristics of all recipients and donors.

VariablesModulation	Group No.	GIM group (SAL+splenectomy)	P-value
N	63	36 (17+19)	P-value
Recipient
Cold ischaemic time, min	202 (162–240)	179 (144–210)	0.016
Anhepatic phase, min	80 (61–106)	79 (64–103)	0.988
Operation time, min	657 (576–746)	685 (558–772)	0.825
Blood loss	3000 (1500–5850)	3050 (1850–4400)	0.760
SFSS	7 (11.1)	4 (11.1)	1.0
EAD	7 (11.1)	2 (5.6)	0.355
Hospital stay	26 (21–33)	25 (20–32)	0.438
ICU stay	14 (11–21)	12 (10–16)	0.048
Severe postoperative complications^*			0.464
3a	26 (41.3)	13 (36.1)
3b	8 (12.7)	2 (5.6)
4a	4 (6.3)	1 (2.8)
4c	1 (1.6)	1 (2.8)
Hospital mortality	4 (6.3)	1 (2.8)
Specific postoperative complications
Hepatic artery thrombosis/pseudoaneurysm+	1 (1.6)	1 (2.8)	0.685
Portal vein thrombosis	4 (6.3)	2 (5.6)	0.874
Hepatic vein thrombosis	0	1 (2.8)	0.184
Bile leakage/stricture	14 (22.2)	6 (16.7)	0.508
Liver hemodynamics
Initial portal flow, ml/min/100 g	156 (115–213)	311 (252–384)	<0.001
Initial HA flow, ml/min	100 (68–134)	49 (39–80)	<0.001
Final portal flow, ml/min/100 g	156 (115–213)	224 (179–267)	<0.001
Final HA flow, ml/min	100 (68–134)	80 (50–120)	0.065
SAL – splenic artery ligation; SFSS – small-for-size syndrome; EAD – early allograft dysfunction; ICU – Intensive Care Unit; HA – hepatic artery. ^* Clavien-Dindo classification. Continuous variables are expressed as the median (IQR). Categorical variables are expressed as number of patients (percentage).

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