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Keywords:

  • Orthotopic liver transplantation;
  • Ventricular function;
  • Echocardiography-shortening fraction

Abstract

  1. Top of page
  2. Abstract
  3. References

Abstract Hemodynamic alterations are a well-known phenomenon that influence the outcome of orthotopic liver transplantation (OLT). Whether or not myocardial dysfunction, which has various causes, contributes to this instability is still debated. Previous transesophageal echocar-diography (TEE) studies have presented controversial data, not leading to final clarification. This is mainly because the impact of other contributing factors (inotropic support, alternating preload conditions and temperature) remained unaccounted for. We therefore measured the left ventricular shortening fraction (LVSF), a parameter reflecting myocardial contractility, in 10 consecutive patients undergoing OLT without veno-venous bypass. We measured during preparation (PP), during the anhepatic (AP) phase and the immediate reperfusion phase (RP). During the AP we observed a significant decrease of LVSF which never fell to subnormal levels in the majority of our patients, whereas during the RP, LVSF returned to PP values. These findings support the assumption that myocardial function is influenced by OLT, but that it plays only a minor role in the occurrence of hemodynamic instability, which could mainly be attributed to volume fluctuations.

Abbreviations
AP

Anhepatic phase

Cl

Cardiac index

EF

Ejection fraction

HR

Heart rate

LVSF

Left ventricular fractional shortening

MAP

Mean arterial pressure

OLT

Orthotopic liver transplantation

PP

Preparation phase at hemodynamic stability

RP

Reperfusion

TEE

Transesophageal echocardiography

References

  1. Top of page
  2. Abstract
  3. References
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