19 July 2022>: Original Paper
Graft Inflow Modulation in Living-Donor Liver Transplantation: Hepatic Hemodynamic Changes in Splenic Artery Ligation and Splenectomy
Che-Min Su ABCDEF , Tsung-Ching Chou ABD , Tsung-Han Yang ABD , Yih-Jyh Lin ABDEF*DOI: 10.12659/AOT.936609
Ann Transplant 2022; 27:e936609
Table 4 Operative characteristics of all recipients and donors in the modulation group.
VariablesModulation | Subgroup 1SAL | Subgroup 2Slenectomy | P |
---|---|---|---|
N | 17 | 19 | |
Recipient | |||
Cold ischaemic time, min | 185 (154–234) | 164 (137–196) | 0.149 |
Anhepatic phase, min | 79 (66–107) | 78 (59–94) | 0.366 |
Operation time, min | 695 (594–838) | 657 (552–745) | 0.199 |
Blood loss | 3100 (1225–4150) | 2800 (1900–6500) | 0.334 |
SFSS | 3 (17.6) | 1 (5.3) | 0.238 |
EAD | 0 | 2 (10.5) | 0.169 |
Hospital stay | 21 (19–28) | 26 (21–35) | 0.172 |
ICU stay | 11 (10–13) | 13 (11–18) | 0.009 |
Severe postoperative complications* | 0.391 | ||
3a | 6 (35.3) | 7 (36.8) | |
3b | 0 | 2 (10.5) | |
4a | 1 (5.9) | 0 | |
4c | 0 | 1 (5.3) | |
Hospital mortality | 0 | 1 (5.3) | |
Specific postoperative complications | |||
Hepatic artery thrombosis/pseudoaneurysm + | 1 (5.9) | 0 | 0.284 |
Portal vein thrombosis | 0 | 2 (10.5) | 0.169 |
Hepatic vein thrombosis | 0 | 1 (5.3) | 0.337 |
Bile leakage/stricture | 4 (23.5) | 2 (10.5) | 0.296 |
Liver hemodynamics | |||
Initial portal flow, ml/min/100 g | 292 (238–357) | 319 (250–430) | 0.274 |
Initial HA flow, ml/min | 70 (43–85) | 40 (27–56) | 0.013 |
Final portal flow, ml/min/100 g | 233 (211–273) | 203 (150–270) | 0.188 |
Final HA flow, ml/min | 83 (52–137) | 73 (49–110) | 0.362 |
Decreased PVF (%) | 14.3 (11.0–23.8) | 41.8 (23.6–50.3) | 0.002 |
Increased HAF (%) | 22.5 (5.3–74.7) | 83.4 (3.8–195.2) | 0.129 |
SAL – splenic artery ligation; SFSS – small-for-size syndrome; EAD – early allograft dysfunction; ICU – Intensive Care Unit; PVF – portal vein flow; HAF – hepatic artery flow. * Clavien-Dindo classification. Continuous variables are expressed as the median (IQR). Categorical variables are expressed as number of patients (percentage). |